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

The student/guardian will have to check in with each department in person before receiving sign-off from the Registrar.

Upon check in with the Registrar (S127), the parent/guardian will need to present photo ID to confirm that they are registered as the parent/guardian of the student.

For the Spanish version of this form, please click here:
http://bit.ly/ethswithdrawalsp

Current Location *
Student ID *
Your answer
Student First Name *
Your answer
Student Middle Name
Your answer
Student Last Name *
Your answer
Student Generation, if applicable
Student's Current Grade *
Birth Date *
month/date/year (ex. 2/8/1994)
Your answer
Guardian Name *
Your answer
Guardian Email *
Your answer
Guardian Phone number
Please use hyphens (ex. 555-491-7200)
Your answer
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? *
Withdrawal Requested By *
Comments
Your answer
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.
Submit
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