Student Withdrawal/Transfer Information
PARENTS/GUARDIANS: Complete this form if your child is exiting the HUUSD altogether. Information requested is necessary for the State Board of Education.
*NOTE: Students who will home school but still attend an HUUSD school for 𝙤𝙣𝙚 𝙤𝙧 𝙢𝙤𝙧𝙚 classes DURING THE SCHOOL DAY (even an elective) should 𝗡𝗢𝗧 complete the form.
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BPS (formerly TPBS)
Grade at Time of Withdrawal/Transfer
If during the summer, enter the grade just completed.
Street, Town, Zip
Date of Entrance
Date of Withdrawal/Transfer
Reason for Withdrawal/Transfer
Moving out of district
Approved for High School choice
Transferring to Early College
Transferring to private school
Unhappy with my child’s teacher
Child’s needs are not being met
Child is being bullied
Child will be home schooled for ALL classes during the school day
My child will exit fully but still participate in extracurricular activities (e.g., sports, theatre).
School transferring to
Address of school transferring to
Street, Town, State, Zip
By signing this form, I (parent/guardian) agree that:
Please check each box to indicate your agreement.
I understand the school regulations of attendance and give full consent to the withdrawal/transfer of the above named student.
I assume responsibility for my student to return all devices, textbooks, library books, and other materials and for fulfilling all obligations, financial or otherwise.
Your typed signature will serve as your legal signature.
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This form was created inside of Harwood Unified Union School District.