Permission to Leave

  • Permission to Leave

    • House staff must sign this request BEFORE leaving the house.
    • X's on room checks or restrictions from any SRN department are an automatic denial.
    • The form must be completed in full, submitted for approval, and returned with authorization prior to your departure.
    • Note: requests to leave on Mondays/Wednesdays (during and after SRN classes) will not be approved; requests to leave during tutoring will not be approved; scheduled appointments must be attended and completed prior to leaving. 
  • Today's Date*
     - -
  • SRN House*
  • Date Requesting to Leave*
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Until

  • Nightly assigned chore - you are still responsible for your nightly chore. Make sure to arrive back to the house early enough before curfew to complete your chore. That means you need to plan your return accordingly.

    Reminder

    • Time out requests by students who are 15-year-olds must align with pre-approved times determined by the office
    • Students who are 16 years old have an 8 pm curfew 
    • Curfew is 10 pm for anyone 17 years old and over 

  • House Manager Authorization:

    All items must be answered by a manager.
  • House Manager:*
  • Social Services:*
  • Academics:*
  • Programming:*
  • Financial:*
  • Does the student have an appointment on the date they're requesting?*

  • The appointment must be attended and completed before the student can leave.

  • Is it the student’s laundry day?*
  • Have they completed their laundry?*
  • Have they washed their sheets?*

  • Student's laundry must be completed on their scheduled day, including their bed sheets, before they are allowed to leave.

  • Did you confirm their work hours? If the student has not turned in their work schedule, they may not leave for work.*

  • Your request to leave on {dateRequesting} has been approved. Good job!

    Please confirm:

    I understand if I miss curfew, I will be on house restriction (not even one minute late - be early). This includes work - it must be scheduled in accordance with curfew. 

    I know X’s must be corrected prior to leaving. I understand leaving without permission will result in house restriction.

  • Should be Empty: