Request for On-Campus Time Extension

Request for On-Campus Extended Time

Commuter students are permitted on campus Monday-Friday from 7:30am-5:00pm. From time to time, a student may find the need to be on campus for extended hours to attend enrichment or course activities. If extended hours are necessary, a parent/legal guardian may request an extension of these hours for their student.

This form should be completed by the parent/legal guardian at least 24 hours in advance of the requested extension.

Student First Name

Student Last Name

Email address of student

Date of on-campus extension

Time of extension

Reason for extension

How is student departing from campus?

First and last name of individual picking up student

Students must be picked up by a parent/legal guardian or an individual over the age of 18 designated by the parent/legal guardian. Photo identification is required at time of pickup.

Contact phone number for individual picking up student

I confirm I am the parent/legal guardian of the student listed on this form. By typing my full name below, I give permission for my child to leave campus as indicated on this form.

Email address of parent/legal guardian

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