Change of Dismissal Form Submit a change of dismissal online Submit a change of dismissal using our form below. You must have JavaScript enabled to use this form. Date of Change Student's First Name Student's Last Name Teacher Choose the student's homeroom teacher from the list belowAllenAungBarrettBlair-ChisolmClarkeDollFierekFitzgeraldFossFrazierGirataGroganHughesKim, JKim, KLecherMillerPasicovPennockPerez-GoldRejasRuizSalihSerinoSetliffSiddiquiSimpsonStrongTaherThomasUlshVan BurenWendelWheeler ♦ Dismissal Information ♦ My child is routinely a: Walker Bus Rider Kiss & Rider Child Care Van Rider SACC student ♦ Change Requested ♦ Requested Change ⇒ Please choose the type of change you are requesting, then enter the missing information below (name of student, bus #, etc.) Please choose the requested change below.Meet parents at Kiss and RideMeet _____ at Kiss and RideGet off bus (at different stop) with _____Take bus home with _____Walk home with _____Pickup early in the office at _____ (before 3:30pm) Missing Information ♦ ♦ ♦ Please Note: If your child is going home with a friend, then notes from both families are required to approve a change in dismissal. If the school is unable to process this request, please call me at the phone number listed below. ♦ ♦ ♦ Parent/Guardian First Name Parent/Guardian Last Name Parent/Guardian Telephone Number Parent/Guardian Email Address Leave this field blank
