Red Oak Academy

Red Oak Academy

Instructions for STUDENT WITHDRAWAL FORM:

1. You are advised to speak to the Red Oak Academy Principal and consider all options carefully before you withdraw from your course of study.

2. Students who are withdrawing because of financial difficulties should contact the Red Oak Academy Business Office to discuss the possibility of obtaining financial aid.

3. Please read NOTES below.

4. Fill out PART A only and sign.

5. Fax or mail this form to:

RED OAK ACADEMY
Central Office
2717 Yorkshire St. Irving, TX 75061

Fax:

(214) 889-5068

PLEASE NOTE:

NOTE: (1) In accordance with the compulsory attendance laws of your home state, notice of your withdrawal from Red Oak Academy will be forwarded to your local Independent School district within 30 days.

STUDENT WITHDRAWAL FORM

STUDENT NAME: __________________________________________________________________
SOCIAL SECURITY NO: ______________________________________________________________
GRADE LEVEL:_____________________ STUDENT NO:____________________________________
DATE OF ENROLLMENT:_______________ DATE OF WITHDRAWAL: ________________________
TELEPHONE NO:___________________________ EMAIL ADDRESS:_________________________

REASON FOR WITHDRAWAL:

__________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

I have read and completed this form and understand my rights and responsibilities in withdrawing my student from enrollment in the Internet Home School.

Signature of Parent or Guardian:_____________________________________________________ Date:_______________________

--------------------------------Do Not Fill In Below This Line--------------------------------------

PART B: Checklist for Student Clearance

( ) Returned Textbooks On Loan

( ) Returned All Other Materials

( ) Cleared Accounts Receivable

( ) Provided Record Transfer Data

( ) Completed All Daily Assignments

( ) Completed All Quarterly Exams (if applicable)

Remarks :   ________________________________________________________________________
                  _________________________________________________________________________
                  _________________________________________________________________________
                  _________________________________________________________________________

Approved by Principal :

Signature : _________________________________________________________________________

Date : ______________________