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Withdrawal Form
Firelands Local School District
112 N. Lake St.
South Amherst, OH 44001
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* Indicates required question
Email
*
Your email
Student's Last Name
*
Your answer
Student's First
*
Your answer
Student's Grade:
*
Choose
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Student's Current Address (include city):
*
Your answer
Student's New Address (if applicable)(include city, state, and zip code):
Your answer
Student's Birth Date:
*
MM
/
DD
/
YYYY
Parent/Guardian's Name:
*
Your answer
Parent/Guardian's Name(If applicable):
Your answer
Parent/Guardian's Contact Phone Number:
*
Your answer
Student's Withdraw Date:
*
MM
/
DD
/
YYYY
Reason for Withdrawal:
*
Enrolling in another Ohio Public School
Enrolling in a Private School
Withdrawing from Preschool/Kindergarten
Moving Out of Firelands School District
Moving out of state
Transferring to Home Schooling
Over 18/Non-Attendance
Other
Student's New School/School District:
Your answer
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