Poinciana High School

2300 S. Poinciana Blvd.   Kissimmee, FL 34758

Tel 407-870-4860

Semester Exam

Early Dismissal Authorization

Poinciana High School will have early dismissal during exam week.  If you would like your child to be released early, please fill out the form below and return it to your child’s first period teacher no later than May 30, 2012. If the form is not returned to school, your child will be dismissed at the regular time.

***Once a student leaves campus they may NOT return to ride a bus home.

Complete the following (PLEASE PRINT):

Student ID#: _____________________________                Grade:_________________________

Student Last Name: _______________________________, First: _________________________

I give permission for my child to be released early during exam week for 2012 final exams.

Please select an option below:

_____I will pick up my child

_____My child has own transportation

_____My child has permission to leave with:__________________________________________

_________________________________

Parent/Guardian Name (PRINT)

_________________________________                              _____________________________

Parent/Guardian Signature                                                    Date

(__________)_________________________________

Parent/Guardian Phone

---------------------------------------------Print out and Return--------------------------------------------------