JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Early Dismissal Form
This form must be submitted before 9AM on the day student is to leave early.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Is this form for one student or multiple students?
*
One
Multiple students
Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Student's Teacher's Last Name
*
Your answer
What time are you picking up your child?
*
Time
:
AM
PM
Full Name of siblings and teachers if Multiple students.
Your answer
The full name of parent/guardian that will be picking up student.
*
Your answer
The phone number of parent/guardian that will be picking up student.
*
Your answer
Reason for Early Dismissal
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of School District of Palm Beach County.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report