PDES Dismissal Change Form SY 24-25
Please use this dismissal form in the event of a same day dismissal change only if you did not send a note in with your child. If the change applies to multiple students, please fill out multiple forms.   

Choose one of the "TODAY" options for today only. If you choose an "EVERY DAY" option, this will change your child's plan for today and every day moving forward. If you require a change other than these options provide, please use the TODAY option for today and send a written note in with your child tomorrow that explains what you need moving forward.

Forms submitted after 1pm may not be received. 
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Student First Name *
Student Last Name *
Day of Dismissal Change (mm/dd/yyyy) 
This should be today's date. Advance submissions are not accepted.
*
MM
/
DD
/
YYYY
Grade & Teacher *
Please dismiss the above named student *
If early dismissal please state the time:
If pickup, state who will pick up. Must be listed in Skyward and/or have pickup placard. *
Parent/Guardian Name: *
Parent/Guardian Phone Number: *
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