"Hall Pass Template"

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Hall Pass
This is to allow (Student’s name) _________________________________________________________
Class / Grade ______________________________________________ __________________________
to go to :
Rest room
Library
Counselor
Computer room
Medical / First aid facility
Cafeteria
Multipurpose room
Administrative office
Locker room
Transport area
Visitors Lounge
Gym
□ -
Other
Specify __________________________________________
Date ______________________________ Time when Student left __________________ AM / PM
Name of Teacher _________________________________ Signature _______________________
Time when student returned ________________________________ AM / PM
Name of Teacher _________________________________ Signature _______________________
www.TeachersPrintables.net
Hall Pass
This is to allow (Student’s name) _________________________________________________________
Class / Grade ______________________________________________ __________________________
to go to :
Rest room
Library
Counselor
Computer room
Medical / First aid facility
Cafeteria
Multipurpose room
Administrative office
Locker room
Transport area
Visitors Lounge
Gym
□ -
Other
Specify __________________________________________
Date ______________________________ Time when Student left __________________ AM / PM
Name of Teacher _________________________________ Signature _______________________
Time when student returned ________________________________ AM / PM
Name of Teacher _________________________________ Signature _______________________
www.TeachersPrintables.net