Three Rivers HomeLink Withdrawal Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please fill out the following form if you intend on withdrawing any of your students for the upcoming 2020-21 School Year. This will not be the official withdrawal form, but will help us to get an idea of the number of students we can expect for this next school year. If you do not intend to withdraw any of your students, you do not need to fill out this form.

What day would you like to set as your official withdrawal date?

Parent Name (First and Last Name) *

Mailing Address *

Phone Number *

Student(s) Name(s) who will be withdrawn (include their grade, gender, and date of birth next to each child being withdrawn) *

Will your student be going to a traditional school? *

Yes

If you said yes to the question above, what is the name of the traditional school you intend on enrolling your student? If you said no, put n/a. *

Will your student be going to Independent Homeschool? *

Yes

If you are moving, what is your new address? (put n/a if you aren't moving) *

Is there another reason for withdrawing? If yes, please list reason. *

Is there anything HomeLink could have done to improve your educational experience? *

Please check that you understand that if you are withdrawing from HomeLink, you will be required to return all library items checked out as well as any technology checked out from HomeLink or you will be fined for those items. *

I have read and understand the terms of returning library/technology items.

Required

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Richland School District #400. Report Abuse

Forms