Request for Change in After School Arrangements
 
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 Lakes Elementary 

 
 
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Please fill out the following form to report any changes to your student(s)end of day routine.
 
NOTE:  ALL CHANGES MUST BE RECEIVED NO LATER THAN 2:00 PM ON THE DAY OF THE CHANGE. 
 
This form will be sent to our Office Professionals.

   
 
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  Select Date
mm/dd/yyyy
   
 
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Please select all that apply
Select at least 1.
 
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
   
 
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(If applicable)
 
   
 
(If Applicable)
 
   
 
Please provide instructions/details regarding who your student will be picked up and/or go home with:
 
**Must have the name of the person your student(s) are being picked up by/going home with.  The pickup person must be on your pickup list and have ID available at time of pickup.  If this does not apply, please type N/A below.**

   
 
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 Done