EARLY PICKUP REQUEST FORM

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Only parents or legal guardians are authorized to complete this form. Person picking up student must present a valid driver's license at time of pickup.

STUDENTS CANNOT BE PICKED UP AFTER 1:30 p.m. After 1:30 p.m., pick up will be at the end of the school day at the main entrance.

Any student leaving before 11:26 a.m. will be marked as a half day absence.

Email *

Student's First & Last Name: *

Grade: *

Pickup Date: *

YYYY

Pickup time: *

Time

Full name of person picking student up: *

Relationship to student: *

Reason for early pickup: *

Full name of person completing this form: *

Relationship to student: *

Please have the student stop at the attendance office in the morning of early pickup to receive an early dismissal pass to present to the teacher at the time of release.

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