學生休學申請單 Student Withdrawal Form
Please notify the school at academy_seattle@tzuchi.us of your withdrawal intent before filling out the form. DO NOT DISTRIBUTE this form to others on your own! Your application will be processed once we receive your withdrawal submission. Refund will be made by check OR back to your credit card in 6-8 weeks after it is processed. Thank you.

~Tzu Chi Academy Seattle Admin Team
Sign in to Google to save your progress. Learn more
目前就讀年級 Current Class Name *
請選擇您孩子目前的班級。 如果學校尚未分班，請填寫上年度就讀班級。Please choose your child's current class. If school has not started, use the previous year class name.
學生中文姓名 Student's Chinese Name *
Fill in the English name if your student does not have a Chinese name
學生英文姓名 Student's English Name *
退款支票title姓名 Refund Check Title *
退款支票上的title姓名。 支票只能開給 ORIGINAL ISSUER。 請用英文姓名。 Please write the name you wish to be on the refund check.  The check can only be made out to the ORIGINAL ISSUER, English only!
支票寄送地址 Refund Mailing Address *
這是您希望將退款支票發送到的地址。 它不必是您的住家地址。This is the address you wish the refund check to be sent to. It does not have to be your home address.
家長或監護人Email Parent/Guardian Email *
家長或監護人電話 Parent/Guardian Phone Number *
休學開始日期 Withdrawal Starting Date *
MM
/
DD
/
YYYY
休學原因 Reason for Withdrawal *
I hereby give Tzu Chi Academy Seattle permission to start the withdrawal process for my child. *
Please type your FULL NAME in English in acknowledgement. This allows Tzu Chi Academy Seattle to formally start the withdrawal process for your child. I understand that by typing my name and clicking on "submit", I am electronically signing this document. For parents & legal guardians only.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms