Promise Program Withdrawal/Transfer Form

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Please fill out this form if you are withdrawing your student (one form per student).

Email *

Student Name

Student's Grade Level *

Is this a withdrawal or transfer? *

Withdrawing from Steilacoom SD for another district (including online school like WAVA or Insight School of WA)

Withdrawing from Steilacoom SD for Homeschool

Transfer to In-Person Classes at Resident SHSD School (Anderson Island, Chloe Clark, Cherrydale, Saltar's Point, Pioneer MS, or Steilacoom HS)

Other:

If you are withdrawing from Steilacoom SD, where will your child be enrolled? (City & State - provide new school if known)

If your child is transferring to in-person classes at their resident SHSD school, which school is it? *

Anderson Island Elementary

Cherrydale Primary

Chloe Clark Elementary

Saltar's Point Elementary

Pioneer Middle School

Steilacoom High School

N/A

Last Day of Classes with Promise Program *

YYYY

Do you have a Steilacoom SD-issued Chromebook? *

Yes

Name of person completing this form? *

Relationship to student? *

Today's Date *

YYYY

Send me a copy of my responses.

Submit

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