Withdrawal Form
* Required
Email address
*
Your email
Student(s) Name(s)
*
Your answer
Class withdrawal:
*
Withdraw from all classes currently enrolled
Withdraw from only a specific class day & time
Required
If checked 2nd box for question above, which day & time
Your answer
Effective date:
*
MM
/
DD
/
YYYY
Reason for withdrawal:
*
Your answer
Are you on auto pay?
*
Yes
No
Is your child on a waitlist?
*
Yes
No
If you answered 'Yes' to question above, would you like to remain on the waitlist?
Yes
No
Send me a copy of my responses.
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