2020-2021 Special Circumstances for Off-Period(s) - Deadline: September 21st
Students may wish to request a specific period off during the day if they have a special circumstance as determined by the administrative committee. The committee will grant or deny the request depending upon the reason and/or availability of classroom space to accommodate the request. You should complete this form AND have your parent send an e-mail to your counselor approving this request.

Counselor E-mail's

Kim Libby (A - Chai) - kimberly.libby@ausinisd.org
Liana Cox (Chaj - Forb) - liana.cox@austinisd.org
Laura Loza (Forc - Jenr) - laura.loza@austinisd.org
Heather Gallier (Jens - McD) - heather.gallier@austinisd.org
Kim Gilbert (McE - P) - kim.gilbert@austinisd.org
Clare Smith (Q - St) - clare.smith@austinisd.org
Nicole Hepburn (Su - Z) - nicole.hepburn@austinisd.org

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Grade *
Student ID *
Last Name *
First Name *
E-mail Address *
Counselor *
Required
Please describe your extenuating circumstance. Be specific and detailed about any personal requests. If work related, you must provide a letter from your employer on their company letterhead or from their work e-mail, including their contact info. Your request may or may not be approved so be mindful of your commitments before hearing back from the committee. Please e-mail supporting documents to your counselor, e-mails are listed above. *
I understand this request is up to the discretion of the special circumstances committee and that my request might not work with my course selection and corresponding schedule. *
My parent knows they must e-mail my counselor approving this request. See list of counselor e-mails at the top of the form. *
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