2025-26 Continuous Enrollment (Opt-Out) Form

Continuous Enrollment Opt-Out Form

Continuous Enrollment Anniversary is February 28, 2025, for the 2025-26 school year!
Only complete this form if your students will NOT be returning for the 2025-26 school year!

If your students are graduating in May 2025 or returning for the 2025-26 school year, DO NOT complete this form.

If you have any questions about Continuous Enrollment or Opting Out, please click here to view HBHA's Opt-Out Withdrawal Policy or contact Admissions Director Bekah Zitron at 913-981-8886 or rzitron@hbha.edu.

Opt-out forms must be submitted electronically.
Parent/Guardian Name *

First NameLast Name
Email
example@example.com
How many student(s) are you withdrawing from HBHA?*
Student Name*

First NameLast Name
2025-26 Grade*
Reason for Opting Out

Please explain reason for withdrawing from HBHA.
What are the primary reasons for withdrawing your student (select all that apply; include in the "other" option any additional details):*

Personal FinancesRelocating 50 Miles or more from HBHAAcademic ConcernsSpecial Education NeedsPersonal/Family ConcernsSocial & Emotional ConcernsReligious Observance (need single gender education)School requestedOther
Please explain:*
Student Name (2)

First NameLast Name
2025-26 Grade
Reason for Opting Out

Please explain reason for withdrawing from HBHA.
What are the primary reasons for withdrawing your student (select all that apply; include in the "other" option any additional details):

Personal FinancesRelocating 50 Miles or more from HBHAAcademic ConcernsSpecial Education NeedsPersonal/Family ConcernsSocial & Emotional ConcernsReligious Observance (need single gender education)School requestedOther
If other, please explain:
Student Name (3)

First NameLast Name
2025-26 Grade
Reason for Opting Out

Please explain reason for withdrawing from HBHA.
What are the primary reasons for withdrawing your student (select all that apply; include in the "other" option any additional details):

Personal FinancesRelocating 50 Miles or more from HBHAAcademic ConcernsSpecial Education NeedsPersonal/Family ConcernsSocial & Emotional ConcernsReligious Observance (need single gender education)School requestedOther
If other, please explain:
Student Name (4)

First NameLast Name
2025-26 Grade
Reason for Opting Out

Please explain reason for withdrawing from HBHA.
What are the primary reasons for withdrawing your student (select all that apply; include in the "other" option any additional details):

Personal FinancesRelocating 50 Miles or more from HBHAAcademic ConcernsSpecial Education NeedsPersonal/Family ConcernsSocial & Emotional ConcernsReligious Observance (need single gender education)School requestedOther
If other, please explain:
Student Name (5)

First NameLast Name
2025-26 Grade
Reason for Opting Out

Please explain reason for withdrawing from HBHA.
What are the primary reasons for withdrawing your student (select all that apply; include in the "other" option any additional details):

Personal FinancesRelocating 50 Miles or more from HBHAAcademic ConcernsSpecial Education NeedsPersonal/Family ConcernsSocial & Emotional ConcernsReligious Observance (need single gender education)School requestedOther
If other, please explain:
Student Name (6)

First NameLast Name
2025-26 Grade
Reason for Opting Out

Please explain reason for withdrawing from HBHA.
What are the primary reasons for withdrawing your student (select all that apply; include in the "other" option any additional details):

Personal FinancesRelocating 50 Miles or more from HBHAAcademic ConcernsSpecial Education NeedsPersonal/Family ConcernsSocial & Emotional ConcernsReligious Observance (need single gender education)School requestedOther
If other, please explain:
Could HBHA done anything different that might have led you to stay?*
If yes, please share what we could have done differently.
Note: Your reason for opting out will not affect your ability to withdraw your child(ren) from HBHA. This is for data collection purposes only.

By opting out of HBHA Continuous Enrollment for the 2025-26 school year, I am aware that my child(ren) will not be enrolled at HBHA for the coming school year, or subsequent school years. Submitting this form does not prevent me/us from enrolling our student(s) at HBHA in future school years. I/we have read and understand HBHA's policies for withdrawing my student(s) and Opting Out of my Continuous Enrollment Agreement with Hyman Brand Hebrew Academy.
My electronic signature below is the same as my handwritten signatures for the purposes of validity, enforceability, and admissibility. *

Clear
Today's Date*
If you have any questions or concerns, please contact the Admissions Director, Bekah Zitron.

Phone: 913-981-8886

Email: rzitron@hbha.edu
Should be Empty:

Continuous Enrollment Opt-Out Form

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