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                               Intent to Withdraw                                                                 
Medina Christian Academy
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*Please Read Carefully*                                                                                                        This form will be used to communicate the intention to withdraw a currently enrolled student(s). Please be reminded that in accordance with the Continuous Enrollment Agreement, this form must be submitted by January 28th to avoid late withdrawal fees. Forms submitted on or after March 1st will be subject to the fees outlined in the Continuous Enrollment Agreement.
Enter Student's Name(s)   (one response per family) *
Typing your name below will be considered by MCA as your written signature, and indicates that you DO NOT desire for your student(s) to be re-enrolled at MCA for the 2022-2023 school year. Enter your name below: *
Please briefly describe the reason for your student's anticipated withdrawal. *
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