Dismissal Information Form
This form should be used to indicate a change in an Elementary School scholar's dismissal.
What is today's date?
What is your phone number?
Who is your scholar?
What is your scholar's grade level?
Which of the following categories indicates the reason for completing this form?
Change in Tutoring Information
Change in Daily Dismissal
Pick Up Early
Brief Explanation: I am writing this note to make you aware of the following information for TODAY ONLY...
Please type in your name to provide an electronic signature.
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