VACATION REQUEST FORM

  • SOUTH ALLEGHENY SCHOOL DISTRICT

    2743 Washington Boulevard                            H.S. Principal - Jeffrey Solomon

    McKeesport PA 15133                                        M.S. Principal - Lisa Duval

    412-675-3070                                                     M.S./H.S. Asst. Principal - Hal Minford

    Fax 412-673-4903

     

    EDUCATIONAL VACATION FORM

    Please complete the following form and return it to the building Principal's Office prior to your vacation period.

     

    __________________________________________                                          ___________________________________

    Parent Name                                                                                       Child Name

                                                                                                             ___________________________________

                                                                                                             Grade/ Homeroom

    ___________________________________________                                        ____________________________________

    Days Covering Vacation                                                                        Geographical Location visited

    In my estimation, the educational values obtained by my child as a result of this experience are as follows:

     

     

     

    It is my understanding that contact will be made with the school to determine what requirements or assignments must be fulfilled in order to maintain my child's preparedness in the classroom. Upon return, it is my understanding that all assignments will be completed within a reasonable time period.

    ____________________________________________                            __________________________________________

    Administrator's Signature                                                            Parent's Signature