Sample Letter of Withdrawal and Request for Transfer of Records
(for families filing a Private School Affidavit)
(Your Families School Name Here)
Your Address • City, State, Zip • Your Phone Number
Withdrawal and Request for Transfer of Records
John Jones, Principal
Name of Public School
Dear Mr./Mrs. Principal:
The following children are withdrawing from attendance at (Name of Public School)
effective on August 10, 2009. They have enrolled in (Name of your School, PSP).
Please forward their school records, including grades and health records.
[Follow this sample, if you have filed your own private school affidavit to both withdraw
your children from school and request their records to be transferred to your new private
school. Be sure that the effective date is either the first day of school or the first day
your children will be absent from the old school.]