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Green Woods Charter School Dismissal Change Form

The GWCS school day ends at 3:10 pm. To dismiss your child differently at the END of the school day, please submit this form no later then 1pm on the day of the dismissal change.

Student First Name*

Answer Required

Student Last Name*

Answer Required

Date of Change*

Answer Required

Student will be changing to:*

Answer Required

Walker (2nd grade and up or accompanied by older sibling)

Pick up by parent/guardian

Pick up by other adult

Early Dismissal

Other:

If student is being dismissed early, indicate the time of pick up. Please note all early dismissals must be prior to 2:30.

Answer Required

If another adult is picking up your student please provide their name below:

Answer Required

Parent/guardian name*

Answer Required

Email Address*

Answer Required

Today's date*

Answer Required

Confirmation Email

Email Required