SAMPLE Early Release Student Name: ________________ Date: __________ Time: ________ Reason: ______________________ ______________________________ ______________________________ ______________________________ Excused: Yes No Authorized Signature:____________________	Early Release Student Name: ________________ Date: __________ Time: ________ Reason: ______________________ ______________________________ ______________________________ ______________________________ Excused: Yes No Authorized Signature:____________________
Early Release Student Name: ________________ Date: __________ Time:_________ Reason: ______________________ ______________________________ ______________________________ _____________________________ Excused: Yes No Authorized Signature:____________________	Early Release Student Name:________________ Date: __________Time: _________ Reason: ______________________ ______________________________ ______________________________ ______________________________ Excused: Yes No Authorized Signature:____________________

III. 9