Student Withdrawal Form - CDLC€¦ · Class Days/Time: _ Date of last day student will/did attend: _ I understand that by completely filling out this form and promptly returning/mailing

STUDENTWITHDRAWALFORMIamherebyinformingChildDevelopment&LearningCenter(CDLC)ofthewithdrawalofmychild:

Child’sName:____________________________________________Teacher:___________________________________

ClassDays/Time:________________________________Dateoflastdaystudentwill/didattend:__________________

Iunderstandthatbycompletelyfillingoutthisformandpromptlyreturning/mailingittotheaddressbelow,IamofficiallywithdrawingmychildfromChildDevelopment&LearningCenter(CDLC),andthatanytuitionrefundduewillbemailed(seehandbookfordetails).

_____________________________________________ _________________________________________________Parent/GuardianName(pleaseprint) Parent/GuardianSignature

PleasereturntotheCDLCoffice,faxto952-898-9379,ormailto:

ChildDevelopment&LearningCenter13801FairviewDriveBurnsville,MN55337

ForOfficeUseOnly:DateReceived:_____________RefundDue?______________DateMailed:______________Amount:______________

ExitSurveySothatwemaycontinuetoimprove,andmakeinformeddecisionsaboutCDLC,pleasetakeamomenttoletusknowwhyyouhavewithdrawnyourchild.

Iamwithdrawingmychildbecause:

o Daycare/Workschedulingconflicts

o We’removing

o Costoftuition/monetaryconcerns

o Other:______________________________________________________________________________________

Documents

Student Withdrawal Form - CDLC€¦ · Class Days/Time: _____ Date of last day student will/did attend: _____ I understand that by completely filling out this form and promptly returning/mailing

Student Withdrawal Form - CDLC€¦ · Class Days/Time: _ Date of last day student will/did attend: _ I understand that by completely filling out this form and promptly returning/mailing