Student Withdrawal Notice

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:*