FOR OFFICE USE ONLY

 

WITHDRAWAL FORM

 

Student Name:                    

 

ID#             GR/TEAC:                  

 

TRANSFERRING TO:                          

 

LAST DAY ATTENDED            WITHDRAWAL DATE:           

 

______ NOTIFY TEACHER

 

______ COPY OF EASY GRADE PRO (FROM TEACHER)

 

______ PERMANENT&HEALTH FOLDERS

 

______ EMERGENCY CARD

 

______ CONFIDENTIAL FILE TO SPECIAL SERVICES

 

______ CHANGE FORM TO SPECIAL SERVICES

 

______ SEND COPY OF FREE/REDUCED APP. TO NEW SCHOOL

 

______ MARK OFF ROSTERS:

1)  CLASS LISTS

2)  BREAKFAST ROSTERS

3)  LUNCH ROSTERS

4)  FREE/REDUCED LISTS

 

 

______ NOTIFY EMIS COORDINATOR FOR TRANSFER OR WITHDRAW

 

______ NOTIFY TRANSPORTATION

 

 

RECORDS SENT:                             

                        DATE