Student Withdrawal Request

Student Withdrawal Form

Parent/Guardian 1

Parent/Guardian 2

Scholar(s)

Scholar 1

Scholar 2

Scholar 3

Scholar 4

Child 5

Student Withdrawal Form

Please Complete All Required Sections

Parent/Guardian 1
Name*

First NameLast Name
Relation to student(s)*

FatherMotherGuardianOther
E-mail*
example@example.com
Parent/Guardian 2
Name

First NameLast Name
Relation to student(s)

FatherMotherGuardianOther
E-mail
example@example.com
Scholar(s)
Select if you'd like a copy of you scholar(s) transcript:

Please send me a copy of transcripts.
Number of scholars currently schooled at MACS*
Scholar 1
Scholar's Name*

First NameLast Name
Gender*

MaleFemaleN/A
Current Grade Year*
Length of Stay at MACS*
Effective withdrawal date*

MonthDayYear
New School's Name*
New School's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
New School's Phone Number
Format: (000) 000-0000.
New School's e-mail
example@example.com
Scholar 2
Sscholar's Name*

First NameLast Name
Gender*

MaleFemaleN/A
Current Grade Year*
Effective withdrawal date*

MonthDayYear
New School's Name*
New School's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
New School's Phone Number
Format: (000) 000-0000.
Scholar 3
Scholar's Name*

First NameLast Name
Gender*

MaleFemaleN/A
Current Grade Year*
Effective withdrawal date*

MonthDayYear
New school's Name*
New School's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
New School's Phone Number
Format: (000) 000-0000.
Scholar 4
Scholar's Name*

First NameLast Name
Gender*

MaleFemaleN/A
Current Grade Year*
Effective withdrawal date*

MonthDayYear
New School's Name*
New School's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
New school's Phone Number
Format: (000) 000-0000.
Child 5
Scholar's Name*

First NameLast Name
Gender*

MaleFemaleN/A
Current Grade Year*
Effective withdrawal date*

MonthDayYear
New School's Name*
New school's address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
New School's Phone Number
Format: (000) 000-0000.
What is the reason for which your family is leaving the school? (Please select all that apply)*

Family movingDissatisfaction with academic programDissatisfaction with faculty or staff memberDissatisfaction with leadership/administrationDiscipline issuesClass size too smallClass size too largeLack of co.curricular activitiesChild's personal/emotional needs not metTransportation problemSpecial education lackingChild's friends/siblings at another schoolPoor communication with PrincipalPoor communication with TeacherPoor communication with StaffProblem with school policiesLooking for different experience/atmosphere for childQuality of facilitiesProblem with other studentFinancial (Fees/Dues)Other
Please specify*

Academics
MACS' education programs are of high quality*

1

2

3

4

5

6

7

8

9

10

1 is Strongly Disagree, 10 is Strongly Agree
My scholar(s) received an excellent education at this school*

1

2

3

4

5

6

7

8

9

10

1 is Strongly Disagree, 10 is Strongly Agree

MACS is doing an excellent job in teaching:*

Rows	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree	Don't Know
Reading
Writing
ELA
Mathematics
Science
History
Physical Education
Music
Coding
Study Skills/ Habits

Resources*

Social*

Rows	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree	Don't Know
Students at MACS show respect for one another
MACS' discipline policies are fair and effective
MACS provides students and teachers with a safe and orderly environment
Teachers and administrators at MACS show genuine concern for the well-being of students
Discipline problems are competently handled
The school tries to bring out the best in each student

Communication*

Please list the top three benefits of the school.*
How would you rate our school to others in the area?*

Better than othersEqual to othersNot as good
On a scale of 1-10, how likely is it that you would recommend MACS to family, friends, and/or colleagues?*

1

2

3

4

5

6

7

8

9

10

1 is not at all, 10 is highly likely

Thank you for providing this information to us. We wish you and your family all the best at your new school.
Your comments are important to us:
Should be Empty:

Strongly Agree

Strongly Disagree

Don't Know

My child has access to a variety of learning resources

MACS' facilities are clean and well-maintained

MACS' co-curricular programmes is broad enough to meet the educational needs of all students in the community

Relationships between teachers and parents are strong

I feel the environment at school is safe for students