Withdrawal Form

Withdrawal Form
This form must be used by parents who intend to withdraw their child from the Orchard Pre-school. The following rules apply:
1. One half term’s notice is required for the withdrawal of a child
2. Notice must be given to the Supervisor in writing (a signed and dated copy of this form may be used for the purpose).
3. *Fee payers only- If notice is not received you will be liable for the equivalent of one half term’s fees.
I hereby give notice that I wish to withdraw my child from the Orchard Pre-school.
Child's name

First NameLast Name
Effective date of withdrawal
Parent's signature
Date

MonthDayYear
Date
Parent's name (block)

First NameLast Name
Parents who give due notice for the withdrawal of a child will be eligible for return of their deposit, either by cheque or bank transfer.
Please tick here to indicate if you would like your deposit refunded or alternatively if you wish to donate your deposit to the Orchard Pre-school to benefit general funds*

DonateRefund
Please indicate how you would prefer your refund.*

ChequeBank Transfer
Cheque to be made out to (name):

First NameLast Name
Address to which cheque may be sent:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Bank:
Name on Account:
Sort Code:
Account Number:
Alternatively, please tick here if you wish to donate your deposit to the Orchard Pre-school to benefit general funds *

DonateRefund
Should be Empty: