Rabun Kids Club: Afternoon Enrichment Program Student Withdrawal Form

Rabun Kids Club: Afternoon Enrichment Program Student Withdrawal Form
- Guardian 1
- Name*
  
  First NameLast Name
- Relation to student(s)*
  
  FatherMotherGuardianOther
- E-mail*
  example@example.com
- Prior Country of Residency*
- Guardian 2
- Name
  
  First NameLast Name
- Relation to student(s)
  
  FatherMotherGuardianOther
- E-mail
  example@example.com
- Child(ren)
- Number of your children currently enrolled in the Rabun Kids Club: Afternoon Enrichment Program*
- Child 1
- Student's Name*
  
  First NameLast Name
- Gender*
  
  MaleFemaleN/A
- Current Grade Level in School*
- Effective withdrawal date*
  
  MonthDayYear
- Child 2
- Student's Name*
  
  First NameLast Name
- Gender*
  
  MaleFemaleN/A
- Current Grade Level in School*
- Effective withdrawal date*
  
  MonthDayYear
- Child 3
- Student's Name*
  
  First NameLast Name
- Gender*
  
  MaleFemaleN/A
- Current Grade Level in School*
- Effective withdrawal date*
  
  MonthDayYear
- Child 4
- Student's Name*
  
  First NameLast Name
- Gender*
  
  MaleFemaleN/A
- Current Grade Level in School*
- Effective withdrawal date*
  
  MonthDayYear
- Child 5
- Student's Name*
  
  First NameLast Name
- Gender*
  
  MaleFemaleN/A
- Current Grade Level in School*
- Effective withdrawal date*
  
  MonthDayYear
- Reason for Withdrawing from the Rabun Kids Club: Afternoon Enrichment Program*
- Thank you for providing this information to us. We wish you and your family all the best in your endeavors.
- Your comments are important to us:
- Should be Empty:

Rabun Kids Club: Afternoon Enrichment Program Student Withdrawal Form

Guardian 1

Guardian 2

Child(ren)

Child 1

Child 2

Child 3

Child 4

Child 5