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PMS Study and Learning Assistance Hour
Please complete this form in its entirety in order for your student to attend the PMS Study and Learning Assistance Hour.

Study and Learning Assistance Hour: Mondays through Thursdays from 3:15pm to 4:15pm in the PMS Library.

Student ID # *
Your answer
Student last name *
Your answer
Student first name *
Your answer
Parent/Guardian first and last name *
Your answer
Parent/guardian email address *
Your answer
Parent/guardian contact phone number *
Your answer
Name of Medical Insurance Company *
Your answer
Group/Coverage Number *
Your answer
Parent: By typing your name below, you certify that all Emergency Medical information on file with the District is current. (If your information needs updating, please come to the school office to do so.) *
Your answer
Student: Please type your name below, acknowledging that you have read and understand the Study & Learning Assistance Hour expectations. *
Your answer
Parent/guardian: Please type your name below, acknowledging that you have read and understand that Study and Learning Assistance Hour expectations. *
Your answer
Is your student allowed to leave PMS Study & Learning Assistance Hour if he/she finishes before 4:15pm?
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