Parent Permission to Leave School Early Form
Complete this form to authorize your child’s early dismissal from school. All information is required for processing your request.
Student's Full Name
*
First Name
Last Name
Grade or Class
*
Date of Early Dismissal
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Requested Time for Early Dismissal
*
Hour Minutes
AM
PM
AM/PM Option
Reason for Early Dismissal
*
Parent/Guardian Full Name
*
First Name
Last Name
Relationship to Student
*
Please Select
Mother
Father
Legal Guardian
Other
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email Address
*
example@example.com
Submit Permission
Should be Empty: