Parent/Guardian One-Day Pickup
This online form must be completed by 1pm (Monday, Tuesday, Wednesday, and Friday) or by 11am (Thursdays). Please call the Gates Office at 978-266-2570 if your request is after these times.

Please use to request one-day parent/guardian pickup. Students will be picked up in the 6th grade pod at dismissal. If student is being picked up earlier in the day, parent/guardian will sign students in the office. We request that parents do NOT pickup up students in office at dismissal time, which begins at 3:10.

Today's Date
MM
/
DD
/
YYYY
Student Last Name *
Your answer
Student First Name *
Your answer
Teacher Name/Room Number (Grade) *
Student's Regular Bus Number is *
Your answer
One-Day Pick-up Date *
Date student will be picked up.
MM
/
DD
/
YYYY
Dismissal Pick-up Time *
Select yes if student(s) is/are to be picked up at dismissal time, if no indicate time below.
Pick-up Time
Specific time if NOT dismissal time.
Time
:
Parent Contact CELL PHONE Number *
Please provide a cell phone number (xxx-xxx-xxxx) in case we need to contact you.
Your answer
You must select "yes" to electronically sign this request *
Person Picking Student Up *
Please provide name of person picking student up if NOT parent.
Submit
Never submit passwords through Google Forms.
This form was created inside of Acton-Boxborough Regional School District. Report Abuse - Terms of Service