VRA Dismissal Change Form 2020-2021

	We accept dismissal changes up until 2:15 PM every day except Wednesdays. 1:15 PM is the deadline on Wednesdays. Dismissal Change Requests will not be read after cutoff times. For Middle School Students, please select the 7th period teacher.

Please enter the names of the students whose dismissal will be changed.

		First Name		Last Name		Teacher's Name
Student 1
Student 2
Student 3
Student 4
Student 5

Please dismiss my student to (pick one):*

	Car pick up line
	Greenleaf Biker/Walker/Golf Cart Station
	Austin Park Biker/Walker/Golf Cart Station
	Extended Day
	Bus

Other

3.	What is the first day this dismissal change will be in affect?*

4.	What is the last day this dismissal change will be in affect?*

5.	Additional comments:

6.	Your full name:*

7.	Your relationship to the student:*

8.	Your email address:*

Done