Ashburton Change of Dismissal Form

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This form is used to communicate a change to your student's regular dismissal plans for the day.

This form must be submitted by 2:15pm the day of the change, otherwise your student will follow their regular dismissal routine.

Early pickups are cut off at 2:45pm. After 2:45pm, we not be able to support early pickups outside of the schoolwide dismissal routine.

Please communicate any permanent changes of dismissal plans to your student's teacher and the office by email.

Today's Date *

YYYY

What is your child's last name? *

What is your child's first name? *

Who is your child's teacher *

Method of Dismissal *

Early pickup from office

Change of bus

Pick up as a walker

Pick up as a car rider

Other:

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This form was created inside of Montgomery County Public Schools.

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