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
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
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