Student Withdrawal Form

Student Withdrawal Form

St. Paul's Christian School
NAME OF CHILD:*

First NameLast Name
CLASSROOM:*
DATE FORM COMPLETED:

MonthDayYear
Date
CHILD'S LAST DATE OF ATTENDANCE:*

MonthDayYear
Date
REASON FOR WITHDRAWAL:
Is your family interested in re-enrolling in the future?*

YesNo
If yes, when?
TERMS and CONDITIONS

PARENT OR GUARDIAN ACKNOWLEDGEMENTS REGARDING WITHDRAWAL
- I understand that by withdrawing from St. Paul's Christian School, I am releasing all rights to my child’s placement.
- I understand that if my family wishes to re-enroll in the future, we will be placed on the waitlist in the appropriate order. No preference will be given to us as a previously enrolled family.
- I understand that I am responsible for paying the assessed withdrawal fee, if required. I also understand that all withdrawals require at least a one month written notice, and if I have not provided sufficient notice, I may also be assessed an additional fee equal to one month tuition.
PARENT NAME: *

First NameLast Name
PARENT SIGNATURE:*

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PARENT EMAIL:*
example@example.com
Should be Empty: