LHS Absence / Tardy / Change of Dismissal

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Please use this form to submit absences, late arrivals or changes to dismissal plans. This form is only seen by the office; please share any pertinent info with your student's teacher and/or the school nurse as well.

All fields marked with a * are required. You may skip any non-applicable fields. Make sure to click SUBMIT at the end!

**ABSENCES/TARDIES MUST BE REPORTED BY 8:00 am.**

**DISMISSAL CHANGES MUST BE REPORTED BY 1:00 pm.** Any changes needed after 1:00 pm must be called into the office at 603-436-1708.

When dismissing your student early, plan to pick up before 2:10. After 2:10, the office and classrooms are busy gearing up for dismissal and you may be asked to wait until your student’s regular dismissal time.

We cannot dismiss a child from their classroom until you arrive at the school.

Email *

STUDENT LAST NAME: *

STUDENT FIRST NAME: *

Teacher: *

Name of parent/guardian filling out form: *

This notification is for: *

TODAY ONLY

The following date(s) - please specify in "NOTES" below

a PERMANENT dismissal change

NORMAL dismissal plan: *

Walker / pick up

PEAK

Bus P2 (Osprey/Blue Heron)

Bus P10 (Islington/Cate/Colombia/Madison)

Bus P16 (Sagamore/Gosport/Ledgewood)

Camp Gundalow

My student will be ABSENT due to:

~SKIP this question if your child is not ABSENT~

Sickness

Appointment

Family / Travel

religious event

Other (please specify below)

Clear selection

My student will be LATE due to (please note expected arrival time in NOTES):

~SKIP this question if your student is not LATE~

Appointment

Family/Travel

Religious event

Other (please specify below)

Clear selection

My student has a DISMISSAL CHANGE.

NEW DISMISSAL PLAN:

Early dismissal - Please note time and if your child will return or not in the Notes field. Plan to pick your child up by 2:10. We cannot dismiss a child from their classroom until you arrive at the school.

Walker/Pick-up

PEAK

Bus P2 (Osprey Dr/Blue Heron Dr)

Bus P10 (Islington/Cate/Colombia/Madison)

Bus P16 (Sagamore/Gosport/Ledgewood)

After school activity (sport, Planet Rangers, Community Campus, etc - please specify in NOTES))

Clear selection

NOTES (ie: absence/tardy reason; time of early pick up and name of adult picking up student; after school activity; other) *

Clear form

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