Palencia Elementary Dismissal Change Form 2021-2022
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We accept dismissal changes up until 2:00 PM every day except Wednesdays. 1:00 PM is the deadline on Wednesdays. Dismissal Change Requests will not be read after cutoff times.
Please enter the names of the students whose dismissal will be changed.
First Name
Last Name
Teacher's Name
Student 1
--Please Select--
Kindergarten - Jessica Banks
Kindergarten - Nicole Butrimus
Kindergarten - Alana Evatt
Kindergarten - Sally Huster
Kindergarten - Cheryl Kerekes
Kindergarten - Allison Oester
Kindergarten - Audra Schaney
Grade 1 - Martha DeVane
Grade 1 - Dana Kelly
Grade 1 - Jennifer Jackson
Grade 1 - Amanda Meyer
Grade 1 - Ashley Roldan
Grade 1 - Michon Simanoff
Grade 2 - John Ackerman
Grade 2 - Alison Andreoni
Grade 2 - Annie Campbell
Grade 2 - Jennifer Case
Grade 2 - Courtney Downs
Grade 2 - Karen Frazier
Grade 2 - Sharon Hackney
Grade 2 - Kathy Young
Grade 3 - Laura Banks
Grade 3 - Jacob Bultema
Grade 3 - Dawn Caronna
Grade 3 - Whitney Fischer
Grade 3 - Samantha Hays
Grade 3 - Shanna Klauk
Grade 3 - Jennifer Ledford
Grade 4 - Danielle Hoffman
Grade 4 - Emily Hogan
Grade 4 - Emily Holt
Grade 4 - Lauren Maillo
Grade 4 - Sandy Mercer
Grade 4 - Cristin Schultz
Grade 4 - Stacey Suderman
Grade 4 - Amanda Wadsworth
Grade 5 - Michael Clark
Grade 5 - Tim Duncan
Grade 5 - Debby Gardner
Grade 5 - Jennifer Hughes
Grade 5 - Jennifer Kinnaman
Grade 5 - Nicholas Smith
Grade 5 - Michelle Traylor
Media Specialist - Heather Flowers
Music Teacher - Krishna Chandrasekharan
Student 2
--Please Select--
Kindergarten - Jessica Banks
Kindergarten - Nicole Butrimus
Kindergarten - Alana Evatt
Kindergarten - Sally Huster
Kindergarten - Cheryl Kerekes
Kindergarten - Allison Oester
Kindergarten - Audra Schaney
Grade 1 - Martha DeVane
Grade 1 - Dana Kelly
Grade 1 - Jennifer Jackson
Grade 1 - Amanda Meyer
Grade 1 - Ashley Roldan
Grade 1 - Michon Simanoff
Grade 2 - John Ackerman
Grade 2 - Alison Andreoni
Grade 2 - Annie Campbell
Grade 2 - Jennifer Case
Grade 2 - Courtney Downs
Grade 2 - Karen Frazier
Grade 2 - Sharon Hackney
Grade 2 - Kathy Young
Grade 3 - Laura Banks
Grade 3 - Jacob Bultema
Grade 3 - Dawn Caronna
Grade 3 - Whitney Fischer
Grade 3 - Samantha Hays
Grade 3 - Shanna Klauk
Grade 3 - Jennifer Ledford
Grade 4 - Danielle Hoffman
Grade 4 - Emily Hogan
Grade 4 - Emily Holt
Grade 4 - Lauren Maillo
Grade 4 - Sandy Mercer
Grade 4 - Cristin Schultz
Grade 4 - Stacey Suderman
Grade 4 - Amanda Wadsworth
Grade 5 - Michael Clark
Grade 5 - Tim Duncan
Grade 5 - Debby Gardner
Grade 5 - Jennifer Hughes
Grade 5 - Jennifer Kinnaman
Grade 5 - Nicholas Smith
Grade 5 - Michelle Traylor
Media Specialist - Heather Flowers
Music Teacher - Krishna Chandrasekharan
Student 3
--Please Select--
Kindergarten - Jessica Banks
Kindergarten - Nicole Butrimus
Kindergarten - Alana Evatt
Kindergarten - Sally Huster
Kindergarten - Cheryl Kerekes
Kindergarten - Allison Oester
Kindergarten - Audra Schaney
Grade 1 - Martha DeVane
Grade 1 - Dana Kelly
Grade 1 - Jennifer Jackson
Grade 1 - Amanda Meyer
Grade 1 - Ashley Roldan
Grade 1 - Michon Simanoff
Grade 2 - John Ackerman
Grade 2 - Alison Andreoni
Grade 2 - Annie Campbell
Grade 2 - Jennifer Case
Grade 2 - Courtney Downs
Grade 2 - Karen Frazier
Grade 2 - Sharon Hackney
Grade 2 - Kathy Young
Grade 3 - Laura Banks
Grade 3 - Jacob Bultema
Grade 3 - Dawn Caronna
Grade 3 - Whitney Fischer
Grade 3 - Samantha Hays
Grade 3 - Shanna Klauk
Grade 3 - Jennifer Ledford
Grade 4 - Danielle Hoffman
Grade 4 - Emily Hogan
Grade 4 - Emily Holt
Grade 4 - Lauren Maillo
Grade 4 - Sandy Mercer
Grade 4 - Cristin Schultz
Grade 4 - Stacey Suderman
Grade 4 - Amanda Wadsworth
Grade 5 - Michael Clark
Grade 5 - Tim Duncan
Grade 5 - Debby Gardner
Grade 5 - Jennifer Hughes
Grade 5 - Jennifer Kinnaman
Grade 5 - Nicholas Smith
Grade 5 - Michelle Traylor
Media Specialist - Heather Flowers
Music Teacher - Krishna Chandrasekharan
Student 4
--Please Select--
Kindergarten - Jessica Banks
Kindergarten - Nicole Butrimus
Kindergarten - Alana Evatt
Kindergarten - Sally Huster
Kindergarten - Cheryl Kerekes
Kindergarten - Allison Oester
Kindergarten - Audra Schaney
Grade 1 - Martha DeVane
Grade 1 - Dana Kelly
Grade 1 - Jennifer Jackson
Grade 1 - Amanda Meyer
Grade 1 - Ashley Roldan
Grade 1 - Michon Simanoff
Grade 2 - John Ackerman
Grade 2 - Alison Andreoni
Grade 2 - Annie Campbell
Grade 2 - Jennifer Case
Grade 2 - Courtney Downs
Grade 2 - Karen Frazier
Grade 2 - Sharon Hackney
Grade 2 - Kathy Young
Grade 3 - Laura Banks
Grade 3 - Jacob Bultema
Grade 3 - Dawn Caronna
Grade 3 - Whitney Fischer
Grade 3 - Samantha Hays
Grade 3 - Shanna Klauk
Grade 3 - Jennifer Ledford
Grade 4 - Danielle Hoffman
Grade 4 - Emily Hogan
Grade 4 - Emily Holt
Grade 4 - Lauren Maillo
Grade 4 - Sandy Mercer
Grade 4 - Cristin Schultz
Grade 4 - Stacey Suderman
Grade 4 - Amanda Wadsworth
Grade 5 - Michael Clark
Grade 5 - Tim Duncan
Grade 5 - Debby Gardner
Grade 5 - Jennifer Hughes
Grade 5 - Jennifer Kinnaman
Grade 5 - Nicholas Smith
Grade 5 - Michelle Traylor
Media Specialist - Heather Flowers
Music Teacher - Krishna Chandrasekharan
Student 5
--Please Select--
Kindergarten - Jessica Banks
Kindergarten - Nicole Butrimus
Kindergarten - Alana Evatt
Kindergarten - Sally Huster
Kindergarten - Cheryl Kerekes
Kindergarten - Allison Oester
Kindergarten - Audra Schaney
Grade 1 - Martha DeVane
Grade 1 - Dana Kelly
Grade 1 - Jennifer Jackson
Grade 1 - Amanda Meyer
Grade 1 - Ashley Roldan
Grade 1 - Michon Simanoff
Grade 2 - John Ackerman
Grade 2 - Alison Andreoni
Grade 2 - Annie Campbell
Grade 2 - Jennifer Case
Grade 2 - Courtney Downs
Grade 2 - Karen Frazier
Grade 2 - Sharon Hackney
Grade 2 - Kathy Young
Grade 3 - Laura Banks
Grade 3 - Jacob Bultema
Grade 3 - Dawn Caronna
Grade 3 - Whitney Fischer
Grade 3 - Samantha Hays
Grade 3 - Shanna Klauk
Grade 3 - Jennifer Ledford
Grade 4 - Danielle Hoffman
Grade 4 - Emily Hogan
Grade 4 - Emily Holt
Grade 4 - Lauren Maillo
Grade 4 - Sandy Mercer
Grade 4 - Cristin Schultz
Grade 4 - Stacey Suderman
Grade 4 - Amanda Wadsworth
Grade 5 - Michael Clark
Grade 5 - Tim Duncan
Grade 5 - Debby Gardner
Grade 5 - Jennifer Hughes
Grade 5 - Jennifer Kinnaman
Grade 5 - Nicholas Smith
Grade 5 - Michelle Traylor
Media Specialist - Heather Flowers
Music Teacher - Krishna Chandrasekharan
Please dismiss my student to (pick one):
*
Early Dismissal
Palencia Biker / Walker
Kensington Biker / Walker
Palencia Parent Pickup
Kensington Parent Pickup
Extended Day
Bus
Other
What is the number of the bus which the student/s will be riding?
*
What time will the student/s be picked up?
*
What is the first day this dismissal change will be in affect?
*
What is the last day this dismissal change will be in affect?
*
Additional comments:
Your full name:
*
Your relationship to the student:
*
Your email address:
*