Student Withdrawal Notice

Please use this form if you are choosing to withdraw your student from Northstar School.

STUDENT WITHDRAWAL FORM

Please fill out this form completely if you are withdrawing your student from Northstar School.
Student Name*
Current grade of student*
The above student will be:*
This withdrawal is effective beginning:*
MM slash DD slash YYYY
Reason for withdrawal*
Father's Name
First Last
Mother's Name
First Last
Name of the person completing this form:*
First Last
Email of the person completing this form:*
By signing here, I authorize the above withdrawal:*