Withdrawal Request
Withdrawal must be made by the 15th of the month PRIOR to when you wish to stop attending. (For example, if you want October to be your last month of lessons, submit this form no later than October 15th. )
Please fill out a separate form for each student.

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Email *
Parent/Guardian First Name *
Parent/Guardia Last Name *
Student(s) Full Name(s) *
Based on today's date, I would like to withdraw from lessons at the END of *
Reason for withdrawal *
If applicable, please feel free to share additional details regarding your reason for leaving. We are always striving to be the best, so your feedback is important to us.
Would you like the office to contact you to discuss any of the information you noted in this form?
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I also understand: *
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