Change in Dismissal Form Please use this form to report temporary changes in transportation plans to the Franconia main office by 3:00 p.m. on the day of the change. If the change in transportation involves another student, families of BOTH students must fill out forms. If you prefer to not use this form, please call the main office at 703-822-2200. Permanent changes MUST be reported by calling the main office at 703-822-2200. Thank you! This attendance form is to be submitted by the parent/legal guardian only.* Student Information Student First name Student Last Name Teacher Name Grade Level - None -KindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6 Transportation Change Information How does your child regularly go home? - Select -BusKiss & RideWalkAfter School Care ProviderSACC Bus Number Bus Stop Location * Please also contact your child's after school care provider to notify them of the change. * Please also contact Franconia SACC to notify them of the change at 703-822-2260. Select the student's change in dismissal. - Select -BusKiss & RideWalkAfter School Care ProviderSACCGo home with another studentBring another student homeOther Name of parent/guardian picking your child up at Kiss & Ride. Bus Number Bus Stop Location Who will be walking home with your child? Who is your child going home with? Please include the student's name, teacher and mode of transportation. *The other student's family must also submit this form. Who is coming home with your child? Please include the student's name, teacher and mode of transportation. *The other student's family must also submit this form. Other- Please Describe Date of Change in Dismissal Parent/Guardian Contact Information Parent/Guardian First name Parent/Guardian Last Name Phone Number Parent/Guardian Email Address By submitting this form, you are confirming that you are the parent or legal guardian of the student listed above.