MHS Check-Out Request

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THIS FORM IS A PARENT RESOURCE. STUDENTS ATTEMPTING TO COMPLETE THE FORM MAY RESULT IN AN ADMINISTRATIVE REFERRAL.

Parents: Complete this form, preferably prior to the day of checkout.

Students: Day of check out and prior to the time of check out - report to the Attendance Office to receive a check-out pass.

STUDENTS MUST CHECK OUT USING ONE OF THE FRONT OFFICE KIOSKS BEFORE LEAVING CAMPUS.

Email *

Time of Check-Out *

Will Student Provide Their Own Transportation Via Car/Golf Cart? *

Yes

No - Student Check-Out and meet parent in parking lot

No - Parent Pickup in Front Office

Student Grade *

Reason For Check-Out *

Doctor or Dental Appointment

Sick

Court

Other

Optional: Add additional info regarding Check -out here

Date of Check-Out *

YYYY

Parent/Guardian Name & Phone Number *

Name of Person to Check-Out Student (Put SELF if student is leaving on their own) Person must be listed in students Infinite Campus Account. *

Student First and Last Name (Do Not Use Nickname) *

As parent/guardian, I acknowledge that the Attendance Office is NOT responsible for calling my student for check-out and that my student must report to the attendance office to pick up a check-out pass. *

Yes, I acknowledge

Required

A copy of your responses will be emailed to the address you provided.

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