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Withdrawal Form
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* Indicates required question
Email
*
Your email
Student Name
Your answer
Grade
Preschool
Kindergarten
1st Grade
2nd Grade
3rd Grade
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Last day child will attend class (or did attend)
MM
/
DD
/
YYYY
Reason for withdrawal
Moving
Homeshcool (not online)
Virtual School (online)
Other:
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If moving, please list the new address.
Your answer
New School name
Your answer
Do you have a Chromebook to return?
Yes, I will return it to the school office with in 3 days of my child's last school day
No
Clear selection
If there is a balance remaining on my child's food service account,
Send refund to new address
Donate funds to the accounts of kids in need
Other:
Clear selection
I would like to be contacted regarding the reason we are withdrawing
Yes
No
Other:
Clear selection
If you have questions please contact Dana-Lynn Ballou 253-884-4901 or
dballou@steilacoom.k12.wa.us
.
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