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Drop Student Form
Complete this form when you drop a student from your class list. Please make every effort to make contact with the family to make sure that they no longer want the spot or if child is moving where they are moving to. We would like to assist the child in locating another program if at all possible. *Students who are put back on the wait list for the next school year will need to participate in a new screening to determine continued eligibility for Project HELP for the following year.
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* Indicates required question
Email
*
Your email
Teacher Name
*
Choose
Bridges
Clark
Coleman
Duniphan
Edrington
Elam
Flake
Groom
Hays
Herrington
Hewitt
Holsapple
Hutton
LaFrence
Martin
Mast, J.
Morrow
Rakow
Ramey
Ramirez (Previously C. Smith)
Ramsey (Previously A. Bell)
Ruppert
Storm, K.
Strong
Ungrund/Mayhaus
Unzicker
Waller
Wendling
White
Office
Today's Date
*
MM
/
DD
/
YYYY
Student Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Drop From:
*
AM Classroom
PM Classroom
Did not enroll
First Student Day of Attendance (if didn't enroll use today's date)
*
MM
/
DD
/
YYYY
Should this child go back on your wait list?
*
Yes
No
Any information we need to know (wait list for current year, wait list for next year, etc....)
Your answer
Reason for drop?
*
Found another program
Parent changed mind
No transportation
Conflict with session availability
Moving to another district
Other:
If moving to another classroom, which one? (Have you confirmed this move is possible with Elaine? Must do so before talking with parent to determine if new Project HELP classroom has openings)
Your answer
Please list below their new address and phone number:
Your answer
If moving outside our Project HELP classrooms, please list the name and address of the school below:
Your answer
Check all the attempts made to contact parents (three different attempts should be made):
*
Talked to mom
Text
Email
Drive-by
Letter
Other:
Required
Is there anything else we need to know about this child or their family? She has been sick a lot this year, struggles to get up for school in the morning so Mom just wants to drop her. She is young also.
Your answer
A copy of your responses will be emailed to the address you provided.
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