PDES Dismissal Change Form SY 24-25

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Please use this dismissal form in the event of a same day dismissal change that does not allow for a written note to be sent in to your child's teacher. Please fill out one form for each child's dismissal being changed.

Please 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.

Student First Name *

Student Last Name *

Day of Dismissal Change (mm/dd/yyyy) *

YYYY

Grade & Teacher *

PK - Mahoney

PK - Holmes

PK - Dowgiallo/Como

PK - MacQueen

K - Casey

K - Girard

K - Rekos

1 - Amalfetano

1- Dolan

1 - Perrin

2 - Farrelly

2 - Iverson

2 - Towle

3 - Alves

3 - Holden

3 - Morelli

3 - Rosen

4 - Rollins

4 - Turcotte

4 - Willett

5 - Carr

5 - Chadwick

5 - DeFeo

Please dismiss the above named student *

Early Dismissal

Pick up TODAY at 3:13

Bus TODAY

Walker TODAY (K-5 only)

YMCA TODAY (K-5 only)

Pick up EVERY DAY until further notice

Bus EVERY DAY until further notice

Walker EVERY DAY until further notice (K-5 only)

YMCA EVERY DAY until further notice (K-5 only)

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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