Temporary Leave/Withdrawal Notification Form

Learner Name *

First

Last

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Parent/Guardian Name *

First

Last

I am hereby giving my 30 day notice: *

to suspend my learner(s) enrollment
to withdraw my learner(s)

for the month of: *

September
October
November
December
January
March
April
May

I understand and acknowledge that I am responsible for any outstanding or accrued tuition within the 30 days following this notification unless alternative arrangements have been made. I also understand that each family is entitled to one month of suspended enrollment without the obligation to pay tuition. However, if tuition is not paid for the subsequent month, enrollment will not be maintained, and the learner may lose their place in the program.

I understand and acknowledge that I am responsible for any outstanding or accrued tuition within the 30 days following this notification unless alternative arrangements have been made.

Signature *

Clear Signature

Date *

We are so sorry to see you go! Please provide any feedback, comments, or details you would like for us to have.