Forms & Policies » EHS Dismissal Form

EHS Dismissal Form

FILL OUT THE FOLLOWING

 

Please dismiss (name of student):

At (time): 

On (date):

The reason for this dismissal is:

 

 

Signed by  (parent/guardian): 

 

Phone number where I can be reached to verify the dismissal:

 

 

No student will be dismissed unless

• The signer’s name is in our computerized records as the parent or legal guardian.
• The signer answers the phone if a verification call is made.
• The reason for dismissal is clearly stated.
• This form is presented to the proper authority by 7:55 A.M. on the date of the dismissal
 
*Dismissals may be denied under the regulations stated in the Student Handbook.*

 

EVERETT HIGH SCHOOL
DISMISSAL VERIFICATION FORM

 

Student Name: _____________________________      

 

 

Date Dismissed: ________________         Time Dismissed:    _____________    

 

Teacher’s Signature                                Date Work Complete

Period 1______________                        ________________

Period 2______________                        ________________

Period 3______________                        ________________

Period 4______________                        ________________

 

Academy Assistant Principal’s Approval: _______________________

 

Once form is complete, return to the Academy Assistant Principal for absence from class(s) to be waived.