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Withdrawal Form
In order to ensure Cherry Creek Academy has an accurate count for each school year, we ask that you fill out this form only if you do not plan on having your child(ren) return to Cherry Creek Academy.
Email address *
Student 1 Full Name and Current Grade Level *
Your answer
Student 2 Full Name and Current Grade Level
Your answer
Student 3 Full Name and Current Grade Level
Your answer
Student 4 Full Name and Current Grade Level
Your answer
Please list your child(ren)'s homeroom teacher(s). *
Your answer
Effective Date *
MM
/
DD
/
YYYY
New School *
Your answer
New School Full Address *
Your answer
Where will your student(s) be attending school? *
Required
Why did your family choose to leave CCA?
Your answer
Parent/Guardian 1 Full Name *
Your answer
Parent/ Guardian 1 Email *
Your answer
Parent/ Guardian 1 Phone Number *
Your answer
Parent/Guardian 2 Full Name
Your answer
Parent/ Guardian 2 Email
Your answer
Parent/ Guardian 2 Phone Number
Your answer
By typing my name below, I understand that once my student withdraws, my student cannot be re-admitted unless I complete another Wait List Application. I understand that my student's name will move to the bottom of the wait list. *
Your answer
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