Permission Slip for Early Dismissal
Chabad Gaon Academy
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Name of Student *
Name of Parent/Guardian *
Date of Early Dismissal: *
MM
/
DD
/
YYYY
Time of Requested Dismissal  *
Time
:
Reason for early dismissal: *
Will your student be returning to school within the same school day? *
By checking the box below, I hereby give permission for my child to be dismissed from school early on the date and time I indicated above. *
Required
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