Withdrawal Form
We are sorry that your time at our school is over. Please help us to understand the reason or reasons that you decided not to enroll in our school. Your comments and thoughts will help us to improve and address issues that are important to our community. All responses are confidential. Please remember that should you decide to back to us, we will be here and ready to welcome you back!
Student Information
Student Name
*
First Name
Last Name
Student ID number
*
Date of Birth
*
-
Day
-
Month
Year
Date
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Reasons
I wish to withdraw from the following programme
*
General English
IELTS Preparation
Choose reasons for withdrawal
*
Visa decline (provide a copy of immigration letter)
Academic difficulty
Transfer to other college or university (provide a copy of Offer of Place)
Programme does not meet expectations
Family issues
Health
Other
Declaration
Student signature
*
Parent signature (if under 18)
Date
*
Continue
Continue
Should be Empty: