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Early Dismissal Request

Please complete the form below. Once this form is submitted, it is NOT necessary to contact the office. Your request will be processed, and you may pick up your child at the designated time.

Student Name (Please enter First AND Last name)*

Answer Required

Student Grade/Teacher*

Answer Required

Date of Early Dismissal*

Answer Required

Time of Early Dismissal*

Answer Required

Reason for Early Dismissal*

Answer Required

Parent/Guardian Name*

Answer Required

Phone Number*

Number Required

Notes

Answer Required

Confirmation Email

Email Required