Withdrawal 2024-2025

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Please fill out this form to give more information concerning your student's withdrawal from CHA for the upcoming school year.

First and Last Name *

Phone Number *

Email address *

Student Name *

Grade *

1st

2nd

3rd

4th

5th

6th

7th

8th

9th

10th

11th

Other

PARENT CONSENT WITHDRAWAL - PART 1 *

I certify that I represent all legal decision making parties for the student's education.

Required

PARENT CONSENT WITHDRAWAL - PART 2 *

I understand that by checking this box and submitting this form I am ending my child's enrollment at CHA, effective at the end of the current school year or the date indicated on the form if it is a mid-year withdrawal. The child's seat will not be held upon receipt of this form.

Required

PARENT CONSENT WITHDRAWAL - PART 3 *

If circumstances change and I desire to re-enroll my student, I understand that I must contact the admissions office to see if a seat is available and will also be required to pay the standard registration fee per the posted tuition and fees for the school year of desired enrollment.

Required

PARENT CONSENT WITHDRAWAL - PART 4 *

Prior to release of records, students are required to return school owned textbooks, athletic equipment, and any other school owned items and clear all financial accounts including payment of any applicable tuition or withdrawal fees as outlined in the enrollment agreement.

Required

Signature (Please type name.) *

Date *

Comments: *

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