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