20-21 My Child Is Not Returning to SUSD

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Please complete this form for EACH student NOT returning to SUSD.

Email *

Student Last Name *

Student First Name *

Student Date of Birth *

YYYY

Grade Level *

Kindergarten

My Student is Currently Enrolled in: *

DSS

LNS

RPS

SMS

SHS

MGHS

HDPA

By checking the box below, I am verifying that I want to withdraw my child from the school selected above for the 20-21 school year. *

Check here to verify the withdrawal of child named above.

Required

Parent Signature *

By typing your name below, you agree your electronic signature is the legal equivalent of your manual signature and you are verifying all of the information you entered is accurate and true and you agree to have your child withdrawn from the SUSD school stated within this form.

Send me a copy of my responses.

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