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IES Change in Dismissal Form
All changes in a student’s regular dismissal routine must be communicated to the front desk coordinator through the completion of this form by 11:00 am on the date of the change, no exceptions.
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* Indicates required question
Email:
*
Your answer
Student Name (Last, First)
*
Your answer
Child's Class
*
Choose
KA
KB
1A
1B
2A
2B
2C
2D
3A
3B
3C
4A
4B
4C
5A
5B
5C
Student Name (Last, First)
Your answer
Child's Class
Choose
KA
KB
1A
1B
2A
2B
2C
2D
3A
3B
3C
4A
4B
4C
5A
5B
5C
Student Name (Last, First)
Your answer
Child's Class
Choose
KA
KB
1A
1B
2A
2B
2C
2D
3A
3B
3C
4A
4B
4C
5A
5B
5C
Date of Dismissal Change:
*
MM
/
DD
/
YYYY
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