Elementary School Withdrawal Form

Elementary School Withdrawal Form
We're sad to see you go! Please fill out this form to officially withdraw your child from our elementary school.
Student's Full Name
First NameLast Name
Grade
Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade
Last Day of Attendance
MonthDayYear
Date
Reason for Withdrawal
Parent/Guardian's Full Name
First NameLast Name
Parent/Guardian's Email
example@example.com
Parent/Guardian's Phone Number
Please enter a valid phone number.
New School Name
New School Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
Student's Records
Please indicate where you would like the student's records to be sent.
Records Requested By
New SchoolParent/Guardian
Records Delivery Method
MailEmailPick-up
Should be Empty: