Vacation Request Form
* Required
Today's Date:
*
MM
/
DD
/
YYYY
The following child is requesting a vacation:
*
Your answer
The vacation will start on the date:
*
MM
/
DD
/
YYYY
The vacation will end on the date:
*
MM
/
DD
/
YYYY
The vacation is a
*
School Year (9/1/19 - 6/14/20) Vacation ; No vacation during winter break 12/23/19 – 1/3/20
Summer (6/15/2020-8/31/2020) Vacation
For Summer Vacation Only: The child has not taken any school year vacation, please apply vacation coupon.
Yes
I have read and agreed with the Lighthouse Montessori School Vacation Policy on 2019-2020 Parent Handbook Page 7.
*
Agree
Name of parent or legal guardian who completed this form:
*
Your answer
Relationship with the child:
*
Mother
Father
Other legal guardian.
Submit
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