Late Arrival/Early Dismissal Form

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Copy and use as needed:
Lee-Davis High School
Student Name_____________________________Student ID#__________Date________
Time of Early Dismissal
Reason
Time of Late Arrival
Reason
Dates of Absence
Reason
Returned Time_________
Bus Pass __________ (bus number)
____________________________________
Parent Signature
_______________________
o Excused
o Unexcused
Contact Phone Number
Parents, please remember that students must have your note prior to their early dismissal: it
must be turned in to the Attendance Office by 9:00 a.m. the day of the dismissal.
Once the note has been verified with you, the student will receive the pass. Last-minute phone
calls must be verified in writing or by you signing the student out at the Attendance Office.
Thank you for helping us to ensure your student’s safety and success at L-DHS.
-----------------------------------------------------------------------------------------------------------
Copy and use as needed:
Lee-Davis High School
Student Name_____________________________Student ID#__________Date________
Time of Early Dismissal
Reason
Time of Late Arrival
Reason
Dates of Absence
Reason
Returned Time_________
Bus Pass __________ (bus number)
o Excused
o Unexcused
____________________________________
Parent Signature
_______________________
Contact Phone Number
Parents, please remember that students must have your note prior to their early dismissal: it
must be turned in to the Attendance Office by 9:00 a.m. the day of the dismissal.
Once the note has been verified with you, the student will receive the pass. Last-minute phone
calls must be verified in writing or by you signing the student out at the Attendance Office.
Thank you for helping us to ensure your student’s safety and success at L-DHS.
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