Request for Change in Dismissal Plans
NO ONE WILL CHECK THIS FORM AFTER 2:45 EACH DAY. NO CHANGES WILL BE ACKNOWLEDGED/FOLLOWED IF CHANGES ARE MADE AFTER 2:45 FOR THE CURRENT DAY.
First Name of Student
Last Name of Student
Homeroom Teacher's Name
Name of parent/guardian making the request
On the date selected below, my child's dismissal plan will be:
A separate request will be needed for each day the plan is different than the plan on file.
What is the dismissal plan for the selected day?
Early Dismissal: My child will be picked up early (before 2:45 pm)
Bus Rider: My child will take the bus home on this day
At Dismissal Pick-up: My child will be a "pick-up" at dismissal time on this day. (also referred to as a "walker")
After-Care: My child will go to after-care on this day.
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