Pupil Withdrawal Form - Lighthouse printable pdf download

Pupil Withdrawal Form - Lighthouse

Withdrawal August 2017

PUPIL WITHDRAWAL FORM

Parents should complete and return this form to the school if they wish to withdraw their

child from the school.

Name of student:

______________________________________________

Current Class :

______________________________________________

Last day of school will be:

______________________________________________

□

Reason for withdrawal

Transfer to local Dutch School

□

Transfer to local International School

□

Moving Abroad

□

Other __________________________________

Name and address of next school: __________________________________

__________________________________

Forwarding Family Address & Contact Information:

_____________________________________________________________________

______________________________________________________________________

New phone number: ____________________________________________________

New e-mail address: ____________________________________________________

Parent/Guardian Signature______________________________Date:______________

If children have to leave school before the end of the school year, notice should be given 3 months

in advance.

The accounts for any other services provided, e.g. therapies, must be financially settled before the

agreement can be terminated. Please note that student reports are not released until all

outstanding obligations (including financial) to the school have been met.

•

Amalia van Solmsstraat 155, 2595 TA Den Haag

Telephone +31 70 335 56 98

infolse@hsvdenhaag.nl

Part of the Stichting Haagsche Schoolvereeniging

Pupil Withdrawal Form - Lighthouse