School Withdrawal Form Wesleyan Christian Academy > Apply to Wesleyan > Continuous Enrollment > School Withdrawal Form School Withdrawal Form Please complete a separate School Withdrawal Form for each child. Today's Date(Required) MM slash DD slash YYYY Parent's Name(Required) First Last Parent's Email(Required) Parent's Phone(Required)Student's Name(Required) First Last Student's Date of Birth(Required) MM slash DD slash YYYY Student's Current Grade(Required) TK K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Student's Last Day of Enrollment(Required) MM slash DD slash YYYY Reason for Withdrawal(Required) Academics Athletics Behavioral Custody / Family Issues Distance to School Financial Job Change / Employment Medical Relocation School / Family Fit Social Student VISA Issues Other Have you discussed your decision to withdraw with your school principal?(Required) Yes No What School will your child be attending next? Acknowledgement of Understanding(Required)I certify that I represent all legal decision-making parties for the child(ren) listed above and that all parents/guardians agree about the decision to withdraw my child(ren) from Wesleyan Christian Academy. I understand that by submitting the School Withdrawal Form, I am ending my child(ren)’s enrollment at the end of the current school year or by the date indicated above. I understand that should I choose to re-enroll at Wesleyan Christian Academy, I will be required to reapply as a new student, submitting all required documentation and paying all fees required of new students. I understand that the School Withdrawal Form is due by February 1. If not submitted by that date, I will not be refunded the continuous enrollment fee. I understand that Wesleyan Christian Academy’s Late Withdrawal Policy requires that parents withdrawing students after June 1, will be required to pay the portion of the school year completed (if applicable), in addition to a minimum of one quarter’s tuition. This policy is stated in the Continuous Enrollment Agreement I signed when enrolling my child(ren) and is necessary due to the commitments Wesleyan has already made to personnel, supplies, curriculum, and materials based on my child(ren)’s enrollment. I further understand that there are no exceptions to this school board policy. I acknowledge that I have read and agree to Wesleyan’s Withdrawal Policy.Parent's Electronic Signature(Required)Please type your full name as your electronic signature.