Please complete this online form to confirm that you wish to leave the Mutual Fund. By completing this form you agree that the school will leave the Mutual Fund from 31st March 2015. Therefore we recommend that you enter into an arrangement with an external provider or risk meeting the cost of cover with your own delegated budget. 1. School Name2. School Number3. Your Name4. I confirm that I wish to leave the Mutual Fund as from 1st April 2015 5. Form completed byPlease select...Business ManagerChair of GovernorsHead Teacher6. I have entered into a private insurance scheme for cover for staff absence 7. I have reviewed the position and am covering staff absence from the School Budget CaptchaAfter completing this form please ensure you click on the 'send form' button. You will receive an email confirming receipt of this form shortly. If you do not receive this email in the next 5 working days please contact the Mutual Fund Team on 01392 382784 Δ