Student Withdrawal/Transfer Information
PARENTS/GUARDIANS: Complete this form if your child is exiting the HUUSD altogether. Information requested is necessary for the State Board of Education.

*NOTE: Students who will home school but still attend an HUUSD school for π™€π™£π™š 𝙀𝙧 π™’π™€π™§π™š classes DURING THE SCHOOL DAY (even an elective) should 𝗑𝗒𝗧 complete the form.

Email *
Student Name *
(Last, First)
School *
Grade at Time of Withdrawal/Transfer *
If during the summer, enter the grade just completed.
Student Address *
Street, Town, Zip
Date of Entrance *
MM
/
DD
/
YYYY
Date of Withdrawal/Transfer *
the last date your child will attend their HUUSD school
MM
/
DD
/
YYYY
Reason for Withdrawal/Transfer *
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