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Letter of Withdrawal

indicates a required answer

Please complete the Letter of Withdrawal if you are withdrawing from another school and transferring to Willow Ridge Academy.

1. *

Today's Date:

2. *

Parent/Guardian Name(s):

3. *

Place of Residence:

4. *

Current school name:

5. *

Current school address:

6. *

Child(ren) to be withdrawn:

7. *

This is to notify you that I will be withdrawing the above-listed children from your school as of __(date)___ to enroll them in Willow RIdge Academy pursuant to § 48222 of the California Education Code.

8. *

You will be receiving a letter from the private school requesting cumulative records for the above-listed children. If you have any questions, please feel free to submit them in writing.


(Typed name of Parent/Guardian constitutes a signature)