Permanent Dismissal Information For Baker-Butler Elementary School Students Child’s Full Name: (First Name)

Teacher:

(Last Name)

Start Date:

**Please indicate a plan for each day of the week. If more the one bus is used during the week, please indicate bus number for each day of the week. Day

Bus

Pick-Up

EDEP ACAC Program

Club

#____ Monday Tuesday Wednesday Thursday Friday

□ Other means of transportation (please explain):

(Parent’s Signature)

(Date)

Walkers/ Bike Riders

Permanent Dismissal Information For Baker-Butler Elementary School ...

Baker-Butler Elementary School Students. Child's Full Name: (First Name). (Last Name). Teacher: Start Date: **Please indicate a plan for each day of the week. If more the one bus is used during the week, please indicate bus number for each day of the week. Day. Bus. #____. Pick-Up EDEP. Program. ACAC Club Walkers/.

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