Lake Dallas High School Student Withdrawal Form
P. O. Box 548, Lake Dallas TX 75065
940-497-4039, FAX 940-497-3737

Please complete and allow 24 hours for your student withdrawal request to be processed.
Email address *
TODAY'S DATE: *
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STUDENT NAME: *
STUDENT GRADE: *
NEW SCHOOL NAME: *
NEW SCHOOL CITY/STATE: *
EXPECTED WITHDRAWAL DATE: *
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DD
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YYYY
PARENT/GUARDIAN NAME: *
PARENT/GUARDIAN PHONE #: *
Electronic Signature Agreement. By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions. * *
Required
A copy of your responses will be emailed to the address you provided.
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