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Lake Dallas High School Student Withdrawal Form
P. O. Box 548, Lake Dallas TX 75065
940-497-4039, FAX 940-497-3737
Please complete and allow 24 hours for your student withdrawal request to be processed.
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Email
*
Your email
TODAY'S DATE:
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MM
/
DD
/
YYYY
STUDENT NAME:
*
Your answer
STUDENT GRADE:
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Your answer
NEW SCHOOL NAME:
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Your answer
NEW SCHOOL CITY/STATE:
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Your answer
EXPECTED WITHDRAWAL DATE:
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MM
/
DD
/
YYYY
PARENT/GUARDIAN NAME:
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Your answer
PARENT/GUARDIAN PHONE #:
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Your answer
Electronic Signature Agreement. By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions. *
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I ACCEPT
Required
Electronic Signature Acknowledgment. By selecting the "I Accept" button, you are acknowledging your child has not been officially withdrawn. Once a student has returned all school property and satisfied all fines and fees with their home campus the campus registrar will formally withdraw your student.
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I ACCEPT
Required
A copy of your responses will be emailed to the address you provided.
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