Student Withdrawal Form
While we are saddened to see any of our students leave our schools, we recognize that family and work circumstances change often. To withdraw your child, please complete this form to notify the school and begin the withdrawal process.

Your response will help us to expedite records transfer requests.

Please note - before records can be released to your new school(s), all fees must be paid, all technology (Chromebooks) must be returned, all library materials must be returned. Your school will contact you shortly to begin this process.

Email address *
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Parent/Guardian Phone # *
Your answer
Reason for Leaving *
Your answer
If moving, new home address, city, state
Your answer
Name of person completing form *
Your answer
Last Date Enrolled/Withdrawal Date *
MM
/
DD
/
YYYY
Would you like to withdraw ALL of your children from the Elmbrook School District? *
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