JCHS Student Attendance and Early Release Form

Student Attendance and Early Release Form

This form is form is to request or notify the school of the following:

Student Early Release
Student Upcoming Absence(s)
Student Late Arrival

Please use the Student Attendance and Early Release Form to inform us if your child needs to leave school early, will be absent on an upcoming date, or will arrive late. By submitting this form in advance, you help us ensure your child's attendance is accurately recorded and assist us in maintaining a safe and organized environment for all students. Thank you for your cooperation.

Student First Name*

Student Last Name*

Grade:*

Student E-mail

Student Cell*

Please enter a valid phone number

Parent Full Name*

First NameLast Name

Parent Cell*

Please enter a valid phone number

Parent E-mail*

Are you requesting:

Early ReleaseUpcoming AbsenceLate Arrival to School

INFORMATION REGARDING EARLY DISMISSAL

Reason for Early Dismissal:*

Please provide reason for Early Dismissal:*

What is the date of the early dismissal?*

MonthDayYear

What is the time of early dismissal? *

:HourMinutesAM/PM Option

Will the student be returning to school?*

YesNo

Estimated time student will return?*

:HourMinutesAM/PM Option

Please select one of the following that directly applies to your student:*

Please provide the name and relationship of the person you are authorizing to pick up your child.*

Full NameRelationship

INFORMATION REGARDING UPCOMING ABSENCE

Date of Expected Absence*

Reason for Absence*

INFORMATION REGARDING LATE ARRIVAL

Date of Late Arrival*

Time expected back at school*

:HourMinutesAM/PM Option

Reason for Late Arrival to School*

AUTHORIZATION

I, parent/legal guardian of the above-named student at Jewish Culture High School do hereby authorize permission for my child to dismiss early from school at the date and time listed above. I further acknowledge and authorize the manner in which my child will be dismissed and/or accompanied off campus by the person listed.

By submitting this form and signing below, I attest to be the parent or guardian of the above-named student and am granting permission for my child to leave school early at the time and date listed on this form and with the person listed above. Further, I agree to all the terms of this form.

Parent Signature*

Thank You.