DHS Parental Excuse Form For Early Dismissal

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The form must be submitted by 9:30 am on the day of the dismissal. Students are not allowed to leave school after 2:00 pm. All other dismissals must have the parent/guardian/emergency contact present in the front office. Please call the school to ensure your child is dismissed!

A phone number must be provided for your child to be dismissed. All phone numbers that have been submitted will be verified by the school. The student MUST come to the office to be dismissed.

Email *

*****Forms will NOT be accepted after 9:30am.*****

Per Dixie High School policy, all Early Dismissal Forms must be submitted BY 9:30am on the day of dismissal. Students are NOT allowed to leave the school after 2:00pm. Please refer to the top of this document.

Student's Full Name *

Grade *

7th

8th

9th

10th

11th

12th

Early Dismissal Date(s) *

YYYY

Early Dismissal Time *

Time

Please state the reason for your child's early dismissal below. If a reason is not given, it will be marked as "unexcused". If the excuse is medical, then a medical excuse must be provided upon return to school.: *

How will the student be dismissed? *

Student Driver (The phone number listed on the form will be verified by the school and you must call the school to verify the dismissal. The student must come to the office to be dismissed.)

IF NOT A STUDENT DRIVER, STUDENT MUST BE PICKED UP IN THE FRONT OFFICE.

Parent/Guardian Name: *

Phone number for parent or guardian: *

Send me a copy of my responses.

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