4th Grade-Dismissal Plan
For safety, completion of this form by a parent or guardian is necessary before your child starts their first day of school at Jacob Wismer.  If you have a single day change of dismissal plan, please complete the "Single Day Dismissal Plan Change" form by 2:30pm on the day of the change so our attendance secretary can notify your child's teacher.  If you have a permanent change, please submit a new online dismissal plan.

TEACHERS MAY NOT SEE A NEW PERMANENT DISMISSAL PLAN UNTIL THE FOLLOWING SCHOOL DAY SO SUBMIT A SINGLE DAY DISMISSAL PLAN CHANGE FORM IF THE CHANGE IS EFFECTIVE IMMEDIATELY.
Sign in to Google to save your progress. Learn more
Email *
Student's last name *
Student's first name *
Student's grade
MONDAY-Dismissal Plan *
TUESDAY-Dismissal Plan *
WEDNESDAY-Dismissal Plan *
THURSDAY- Dismissal Plan *
Friday Dismissal Plan *
If you answered "Parent/authorized pick-up," list the people/cell phone number who can pick up your child below (they must also be listed in Synergy).
Parent/Guardian who is completing this form (include cell phone number) *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Beaverton School District. Report Abuse
Google Forms