PERRY HIGH SCHOOL MENTORSHIP PROGRAM

Excused School Release Form

Name:  ______________________________

Company/Business Released To:  _________________________________

Mentor’s Name:  _______________________________

Telephone Number:  ____________________________

Date to be Excused:  ____________________________

 

            I have permission to be excused from school on the above date in order to fulfill the requirements of my mentorship with the Perry Mentorship Program

Student Signature:                                 ________________________

Parent/Guardian Signature:                  _________________________

 Date:                                                       _________________________

 

            *  This form should be presented to the Attendance Office at least 24 hours

                prior to the participation date listed above to be kept on file.