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Request to Withdraw a Student

Please complete the form below. Required fields marked with an asterisk * You will have to submit the form for each student that is withdrawing from Bradley County Schools.

Please use this form to request to withdraw a student from Bradley County Schools.

I am requesting to withdraw my child as of*

Answer Required

Student Name*

Answer Required

Child's Date of Birth*

Answer Required

Current Grade Level*

Answer Required

My child will be enrolling at (school name)*

School Name

Answer Required

Street Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

School Phone Number*

Number Required

Parent or Legal Guardian's Signature: (Typing name and completing date will verify information)*

Answer Required

Date*

Answer Required

Confirmation Email

Confirmation Email *

Enter your email address here if you'd like to receive a confirmation upon submitting the form.

Email Required