Request for Late Arrival/Early Dismissal
This request form allows parents/guardians of students with block 1 and/or 4 study halls to give permission for late arrival/early dismissal
Email address *
Student Name *
Name of parent/guardian approving late arrival/early dismissal *
Preferred email of parent/guardian approving late arrival/early dismissal
Preferred phone number of parent/guardian approving late arrival/early dismissal *
Student's grade *
Which blocks does your child have study hall and do you permit your child not to attend? Please select all that apply. Please understand that this is not a full open campus policy. Students with study halls in the middle of their day are required to attend. *
Required
My child's block 2 teachers on Day A and B day are... (this information is only used to deliver the late arrival/ early dismissal pass to your child) *
Parent/Guardian Information Verification (Please check the box below to acknowledge the information provided above is accurate) *
Required
Parent/Guardian Signature (Please type your full name) *
A copy of your responses will be emailed to the address you provided.
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