Withdrawal Form
Use this form to begin the process of a student leaving ETHS.

Upon receipt of the Withdrawal Form, the parent/guardian will receive an email from the Registrar's Office detailing next steps to complete the process.

Withdrawal documents will only be released to the student, parent/guardian.

For the Spanish version of this form, please click here: http://bit.ly/ethswithdrawalsp
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Current Location *
Student ID *
Student First Name *
Student Middle Name
Student Last Name *
Student Generation, if applicable
Student's Current Grade *
Birth Date *
month/date/year (ex. 2/8/1994)
Guardian Name *
Guardian Email *
Guardian Phone number
Please use hyphens (ex. 555-491-7200)
Student's Counselor *
Has 504 plan? *
If yes, ETHS will print the 504 plan upon completion of the Leaving School process.
Has IEP (for Special Ed)? *
Proposed Withdrawal Date *
Last day student will be at ETHS
MM
/
DD
/
YYYY
Reason for Withdrawal/Exit *
Is the student transferring to a school outside of Illinois? *
What is the name of the school that the student will be attending? *
Withdrawal Requested By *
Comments
Medical Records
By completing this form, I am requesting that a copy of the student's current physical exam and immunizations record (required for new school transfer process) be provided to the Registrar's office for me to pick up as part of the withdrawal packet.
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