Shajara Tayyiba Student Late Pick Up Form
All parents / carpool drivers who pick up student(s) from school after 3:35 pm must complete this form before student(s) are released.
It will be the parent's responsibility to pay the late fee before the end of the term regardless of carpool
Late Pick Up Fee is $1/child/minute
Student Name (if picking up more than one child, please list all names)
Name of Carpool Driver, if not parent not picking up
By checking this box I agree to pay the $1/child/minute late fee before the end of the term
Total late fee amount
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