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Student Dismissal
Parents/Legal Guardians may dismiss their student early from school using this form.  Please be prepared for a verification phone call from North Brunswick.  If we are unable to reach you, your student will not be released.

PLEASE NOTE THAT DISMISSAL REQUESTS MUST BE SUBMITTED NO LATER THAN 2 HOURS PRIOR TO THE REQUESTED DISMISSAL TIME AND THAT IT IS YOUR STUDENT'S RESPONSIBILITY TO PICK UP A CHECKOUT PASS FROM THE ATTENDANCE OFFICE AFTER COMPLETION OF THIS FORM.  IF YOUR CHILD IS BEING CHECKED OUT LESS THAN 2 HOURS AHEAD OF TIME, PARENT/GUARDIAN WILL BE REQUIRED TO COME INTO THE SCHOOL TO CHECK OUT THEIR CHILD.

** WE WILL NOT CALL YOUR CHILD OUT OF CLASS **  It is your student's responsibility to pick up their pass.

* If your child needs to check out due to illness while on campus your student must go to the Nurse's Office.  The Nurse will notify you and the Attendance Office staff of your student's need for dismissal.
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Email *
Today's Date *
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Student's Full Name *
Student ID Number
Date of Dismissal *
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Time of Dismissal *
Time
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Reason for Dismissal *
Parent Guardian Phone Number (e.g. 910-371-2261)

Please note that we will call to confirm check out times or if other questions arise so please provide the best contact number.  Again, we will call to confirm the checkout and if we fail to reach you--your student will not be released.
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Parent/Guardian Home Address *
Parent/Guardian Acknowledgement:

I understand that it is my child's responsibility to obtain a pass from the Attendance Office as soon as he/she arrives at school or it may be picked up in between classes.  This pass will allow my student to leave class and go to the Attendance Office to properly check out at the time I have designated above.  Office staff will not call my student out of class for dismissal.  If my child fails to obtain the pass and/or leaves campus without officially checking out in the Attendance Office, I will not be able to use this electronic request form in the future and my child may be considered skipping.  By typing my name below, I am certifying that I am the parent/legal guardian of the student listed on this form and that I consent to verification of my entry by North Brunswick High School's staff.
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