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

How does your child regularly go home?

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.

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 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.