RWGSTEM Withdrawal
An Official Withdrawal Request form must be completed for students who withdraw.
For all withdrawals during the school year, the withdrawal process is completed at the school enrolled. DR. R. W. Goines Stem Academy requires 72 hours to complete the withdrawal packet from the time you make the request.

For withdrawal during the summer months, you may drop off, mail or fax your request to the last school your child was enrolled in. The school staff will notify you when your records are available or you can request to have your records mailed to you.
However, this process can take longer if the student has outstanding fees or school equipment. Upon the request, the student (s) is/are to return all of his/her textbooks, library books, athletic uniforms and/or any other school-­‐provided supplies or equipment. Failure to return school property may delay the process.

• Generally the parent /legal guardian who enrolled the student(s) may withdraw the student(s).
• We need to know the name of the school to which your student will be transferring. If the school is outside Texas, we need to know the name of the state.

WITHDRAWAL – A thirty day advance notice must be given before withdrawal of a student. It is imperative that you fill out the Student Withdrawal Form to withdraw your child from any entity of RWG. Otherwise, you are still incurring monthly charges and late fees on your account. If you withdraw your child and you desire to re-enroll them at a later date, you will be required to pay all fees as a new student.

OFFICIAL RECORDS – There is a $5.00 charge for all record requests. This fee will apply to all current and former RWG families and must be paid at the time the request is made. Requests must be submitted in person, mailed, or faxed. Your request will not be fulfilled if payment has not been received. In addition, all fees, fines and/or account balances owed to RWG, must be paid in full before any official records are issued.

Date of Request
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Student's Full Name & Birth Date
Your answer
Student Address:
Your answer
Current Grade
Please indicate reason for withdrawal:
School Information
Name of New School
Your answer
Address of New School
Your answer
New School District (if known)
Your answer
Contact Number
Your answer
Please indicate if you would like to:
Electronic Signature Page
The electronic signatures below and their related fields are treated by Dr. R.W. Goines STEM Academy like a physical handwritten signature on a paper form.

My signature below affirms that all of the information contained in this enrollment packet is correct, complete, and honestly presented. I understand that withholding or misrepresenting information in this packet may jeopardize my child's enrollment.

Required
Parent Name
Your answer
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Below will be completed by DR. R. W. Goines Stem Academy
Date Received
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YYYY
Time Received
Time
:
Received by:
Your answer
Requested Delayed: Item and/or Amount
Your answer
Requested Delayed: Item and/or Amount
Your answer
Delivered
Date Completed
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Completed by School Personnel:
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