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Regular Program Class Change/ Withdrawal Form
Withdrawal or class change form for San Diego Hua Xia Chinese School Regular Program 2023-24
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* Indicates required question
Parents Name (Last, First)
*
Your answer
Parents Email Address
*
Your answer
Parents Contact Number (Phone Number)
*
Your answer
Parents Home Address
*
Your answer
Student English Name (Last, First)
*
Your answer
Student Chinese Name (Last, First)
Your answer
Student Contact Number (Phone Number)
Your answer
Student's email address
Your answer
Student's Date of Birth
*
MM
/
DD
/
YYYY
Current Enrollment (Grade, Morning or Afternoon Session)
*
Your answer
Current Enrollment Teacher Name
*
Your answer
Withdraw/Change
*
Choose
Withdraw
Change
New Class to Change
*
Your answer
Reason to Withdraw/Change
*
Your answer
Acknowledgement
I acknowledge the withdrawal processing fee $150.00
*
Yes, I understand the withdrawal processing fee.
Yes, I understand the registration and late fee are non-refundable
Yes, I understand there is no fee refund if withdrawal after September 24th, 2023
Required
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