Withdrawal Form - Our Lady Of The Assumption Catholic School printable pdf download

Withdrawal Form - Our Lady Of The Assumption Catholic School

Withdrawal Form

Our Lady of the Assumption Catholic School

• Withdrawal Form must be filled out completely and returned to the school office.

• Student records will not be forwarded and/or released until a completed, signed withdrawal form

is on file with the school office.

• One form per student.

NOTE: Students graduating from eighth grade do NOT need to submit a Withdrawal Form.

School Year _ _________________

Student Name ______________________________________________________________________

Last First

Present Grade ____________ Homeroom Teacher ______________________________________

Forwarding Address (if moving) ____________________________________________

City _______________________ State ___________

Zip Code ____________

Date of Withdrawal ___________

Reason ____________________________________________

Name of School Student Will Attend ____________________________________________________

School Address _________________________________________________________

City _______________________ State ___________

Zip Code ____________

Signature of Parent or Guardian _______________________________________________________

Date _______________________

Office Use Only

School Fees Outstanding _ _____________________________________________________________

Library Books Outstanding _ ___________________________________________________________

Textbooks Outstanding _ ______________________________________________________________

___________________________________________________

Our Lady of the Assumption Catholic School seeks to create a nurturing environment grounded

in the Catholic faith, which provides for the spiritual and academic development of each child.

Withdrawal Form - Our Lady Of The Assumption Catholic School