Student Withdrawal
Parent Name
*
First Name
Last Name
Email
*
example@example.com
Date Head of Schools/Dean of Students was notified
*
-
Month
-
Day
Year
Date
Today's Date
*
-
Month
-
Day
Year
Date
Student 1 Name
*
First Name
Last Name
Student 1 Grade
*
Student 1 Withdrawal Date
*
-
Month
-
Day
Year
Date
Student 2 Name (if applicable)
First Name
Last Name
Student 2 Grade (if applicable)
Student 2 Withdrawal Date (if applicable)
-
Month
-
Day
Year
Date
Student 3 Name (if applicable)
First Name
Last Name
Student 3 Grade (if applicable)
Student 3 Withdrawal Date (if applicable)
-
Month
-
Day
Year
Date
Reasons for Withdrawal/Transfer
*
Moving out of state
Financial
Personal family issues
Academic issues
Discipline issues
Spiritual issues
Philosophical differences
Geographical location
Other (please elaborate)
Please expound on reasons selected above:
Withdrawal Policy
Withdrawal of a student should be given careful consideration. The school has ordered textbooks, planned schedules, and hired teachers based on the number of students enrolled, the following policy will be enforced:
Each family is responsible for tuition and fees as listed according to our Withdrawal Policy in our Family Handbook if you choose to withdraw, or if expulsion occurs before the conclusion of that semester. Grades and transcripts will not be released until full payment and other obligations have been met, including all tuition, fees, and fines. Textbooks and sports uniforms must also be returned.
School to which student is transferring
*
If withdrawing multiple students who will be attending different schools, please list all schools with the student's name.
Signature
*
Type your name to sign: I hereby declare that the information contained is correct and accurate to the best of my knowledge.
Continue
Continue
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