If you have chosen the ‘Pick Up from School’ option in your application form please fill out the following form before September 12Full NameFirst NameLast NameE-mailChild 1Name of ChildFirst NameLast NameName of SchoolGradeClassName of TeacherTime of Dismissal123456789101112Hour001020304050MinutesAMPM Please Specify Area of Pick Up (on school grounds)Child 2Name of ChildFirst NameLast NameName of SchoolGradeClassName of TeacherTime of Dismissal123456789101112Hour001020304050MinutesAMPM Please Specify Area of Pick Up (on school grounds)Child 3Name of ChildFirst NameLast NameName of SchoolGradeClassName of TeacherTime of Dismissal123456789101112Hour001020304050MinutesAMPM Please Specify Area of Pick Up (on school grounds)Child 4Name of ChildFirst NameLast NameName of SchoolGradeClassName of TeacherTime of Dismissal123456789101112Hour001020304050MinutesAMPM Please Specify Area of Pick Up (on school grounds)SubmitOnce we receive your form we will provide you with the name of the individual/s who will be picking up your child/ren from school so you may let the school know. Please note that there will not be any pickup service on the first day of Hebrew School.Note: Please notify our school on a day when pick up will not be necessaryShould be Empty: This page uses TLS encryption to keep your data secure.