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Student Withdrawal Form
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* Indicates required question
Student Name
*
Your answer
School
*
Harvard High school
Harvard Junior High
Jefferson Elementary
Crosby Elementary
Washington School
Required
Date of Birth
*
MM
/
DD
/
YYYY
Current Address
*
Your answer
New Address
*
Your answer
Reason for withdrawing from Harvard District 50
*
Transfer to another Illinois school
Transfer to an out of state school
Transfer to alternate education program
Expulsion
School initiated enrollment termination
Student quit school
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