*
Required
Student ID# :
Student First Name
*
required
Student Last Name
*
required
Does this plan change apply to sibling(s)?*
Yes
No
(Sibling) Student First Name
*
required
(Sibling) Student Last Name
*
required
Add more siblings?*
Yes
No
(Sibling) Student First Name
(Sibling) Student Last Name
(Sibling) Student First Name
(Sibling) Student Last Name
Student Grade*
Select all grades for student(s) that this going home plan change applies to.
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Additional teacher (Same grade/TWIN+)
Kindergarten Teacher
*
required
Please Select…
Carol, Anna
Hiersche, Janae
Martinez, Stephanie
Ortega, Meghan
Rosenberger, Celena
1st Grade Teacher
*
required
Please Select…
Bird, Courtney
Gettling, Katie
Keller, Christena
Leahy, Meaghan
Schroeder, Ashley
2nd Grade Teacher
*
required
Please Select…
Dahlen, Drew
Dewater, Emily
Fowles, Amy
Hang, Danielle
Messina, Sandra
Root, Stacie
3rd Grade Teacher
*
required
Please Select…
Duckart, Nicholas
Gretz, Ken
Leggett, Kristi (Del Valle, M.)
Palmer, Mairead
Rice, Katie
Sibelman, Aubrey
4th Grade Teacher
*
required
Please Select…
Bailey, Lindsey
Bergerson, Katie (Biskupic Knight, C.)
Glem, Tamara
Heniff, Nicole
Lewers, Teresa (Twisselman, A.)
Tanksley, Robyn
5th Grade Teacher
*
required
Please Select…
Curl, Bettina
Galluzzo, Abby
Evans, Chelsey
Irwin, Mark
Potocki, Lucy
Wolfsehr, Margot
Additional Teacher (same grade/TWIN+)
*
required
Please Select…
K: Carol
K: Hiersche
K: Martinez
K: Ortega
K: Rosenberger
1: Bird
1: Gettling
1: Keller
1: Leahy
1: Schroeder
2: Dahlen
2: Dewater
2: Fowles
2: Hang
2: Messina
2: Root
3: Duckart
3: Gretz
3: Leggett (Del Valle)
3: Palmer (Ripley)
3: Rice
3: Sibelman
4: Bailey
4: Bergerson (Biskupic Knight)
4: Glem
4: Heniff
4: Lewers
4: Tanksley
5: Curl
5: Galluzzo
5: Evans
5: Irwin
5: Potocki
5: Wolfsehr
Select teacher of twin sibling
Additional Teacher (same grade/TWIN+)
Please Select…
K: Carol
K: Hiersche
K: Martinez
K: Ortega
K: Rosenberger
1: Bird
1: Gettling
1: Keller
1: Leahy
1: Schroeder
2: Dahlen
2: Dewater
2: Fowles
2: Hang
2: Messina
2: Root
3: Duckart
3: Gretz
3: Leggett (Del Valle)
3: Palmer (Ripley)
3: Rice
3: Sibelman
4: Bailey
4: Bergerson (Biskupic Knight)
4: Glem
4: Heniff
4: Lewers
4: Tanksley
5: Curl
5: Galluzzo
5: Evans
5: Irwin
5: Potocki
5: Wolfsehr
Select teacher of twin sibling
Is this a permanent change?*
Yes
No
Which days?*
Monday
Tuesday
Wednesday
Thursday
Friday
Dates?
*
required
My student will be
*
required
Please Select…
biking.
going home by bus.
bus w/Friend: going home with a friend by bus.
car pick up.
car w/Friend: going home with a friend in the car pick up area
car pick up by an adult other than the parent/guardian.
going to daycare.
walking-Playground Walker.
walking- Ridgeline Walker.
walking w/Friend: walking home with a friend.
staying for after school program
After school program name
*
required
Childcare Name
*
required
Please Select…
Artworld
Bethany Childcare
Goodtime Chinese
Kindercare
Other
Name of Childcare
*
required
Friend's Last Name
*
required
Friend's First Name
*
required
Friend's teacher?
*
required
person picking up student
*
required
Bus Number
*
required
Additional Comments
Please send a confirmation email to the address below*: