Intent to Withdraw from ACHS
If you are planning on withdrawing your child please submit this form so we can prepare paperwork. Your child will need to go to the Counseling Office and pick up a Withdrawal Notice from Mrs. Goertzen on their last day of attendance. This form needs to be signed by all of their teachers.
Student Name *
Your answer
Student Grade Level *
Student's anticipated last day of class *
If exact date is not known please give us your best estimate
Where will you be enrolling your student? *
Please include the city and state along with the school name. If you don't know the specific school then please put city and state.
Your answer
Why are you withdrawing?
Just a short answer i.e, moving, change in custody, etc
Your answer
Parent/Guardian Name *
Your answer
Phone number *
Your answer
Type of phone number *
If moving, new address
In case we need to send a refund, etc
Your answer
Parent filling out form *
Your answer
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