PERRY HIGH SCHOOL MENTORSHIP PROGAM

Release Day Form

Teacher Notification
 

NAME:  ___________________________

DATE TO BE RELEASED:  _______________________

 

            This is to inform you that I will not be in school on the above date in order to fulfill my requirements for the Perry Mentorship Program.  I understand that I am responsible for any and all make-up work for my classes.

 

 

Student Signature  ____________________

 

Teachers Initials:      

____________________

                                                                                                                              ____________________

                                                                                                            ____________________

                                                                                                            ____________________