Please print form, fill out, and fax back to the dean’s office at 603.569.7199. This form cannot be submitted online.

Parents: Please fill in the appropriate information below. Items that are in parentheses require a specific name or number to be filled in. Please mail this form directly to the dean of students’ office or fax to 603.569.7199.

For ______________________________________________________ (print student's name)

Departure Info for: ___________________________________________________ (holiday)

I plan to leave Brewster on _________________(date) at ______o'clock __a.m. __p.m.

I am taking school transportation ____ yes ____ no
to ___ Logan Airport ___ South Station ___ Manchester Airport.

If not taking school transportation, I am going with ___ parents or
__ (with whom)___________________________________________________
I am then taking a __bus __train __plane __I am being picked up
(by whom)________________________________________
The scheduled departure time of the bus, plane, or train is ____ o'clock __a.m. or __p.m.
If by plane, flight number ________ airline name __________________________
to (city, STATE) ___________________________________________

Connecting flight, if any.
flight number ________ airline name __________________________
from (city, STATE) _________________________________________

My final destination is:
(specific host) _____________________________________________
at (phone number) __________________________________________

Return Trip

On the return, I am taking __ bus __ train __ plane
arriving at _______ o'clock __ a.m. or __ p.m.
If by plane, flight number _____________ airline name _____________________
from (city, STATE) _________________________________________

Connecting flight, if any
flight number _____________ airline name _____________________
from (city, STATE) _________________________________________

I will meet the bus/van at __Logan Airport __South Station __Manchester Airport
at ________ o'clock __a.m. or __p.m. to return to BA.
If not taking school transportation, I will come back by __ parents' car
or __ (with whom) ________________________________________,

I will be arriving before 7:45 p.m.