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EHS Student Check Out Authorization and Information Form 2022-2023
The information below will be used in the event that your student needs to be checked out during the course of the school day.
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* Indicates required question
Student's Last Name
*
Your answer
Student's First Name
*
Your answer
Student's School ID Number (Lunch Number)
*
Your answer
Student's Gender
*
Male
Female
Student's Date of Birth
*
MM
/
DD
/
YYYY
Student's Cell Number
Your answer
Student Resides with
*
Mother
Father
Mother & Father
Guardian
Primary Parent/Guardian Last Name
*
Your answer
Primary Parent/Guardian First Name
*
Your answer
Primary Parent/Guardian's Street Address
*
Your answer
Primary Parent/Guardian's City, State, Zip
*
Your answer
Primary Parent/Guardian's Cell Number
Your answer
Primary Parent/Guardian's Work Number
Your answer
Primary Parent/Guardian's Home Number
Your answer
Primary Parent/Guardian's Email
*
Your answer
Secondary Parent/Guardian's Last Name
Your answer
Secondary Parent/Guardian's First Name
Your answer
Secondary Parent/Guardian's Street Address, City, State, Zip (If different from Primary Parent/Guardian's)
Your answer
Secondary Parent/Guardian's Cell Number
Your answer
Secondary Parent/Guardian's Work Number
Your answer
Secondary Parent/Guardian's Home Number (If different from Primary Parent/Guardian's)
Your answer
Secondary Parent/Guardian's Email
Your answer
Please note that there will be no check outs after 2:45 pm on regular school days and 11:45 am on half days. Students MAY NOT check out for lunch. A government issued picture ID is REQUIRED in order to check out a student. If unauthorized persons attempt to check out your student, they will be turned away.
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