* Required

School Withdrawal Form

First Name Parent/Legal Guardianrequired

Last Name Parent/Legal Guardianrequired

Email Addressrequired

Number of Students Withdrawing from ACSrequired

Student 1 Information

First Namerequired

Last Namerequired

Current Graderequired

School Yearrequired

Withdrawal Information

Select option if withdrawal information below applies to all students.

Expected date of withdrawalrequired (mm/dd/yyyy)

Reason for Withdrawalrequired

Student 2 Information

First Namerequired

Last Namerequired

Current Graderequired

School Yearrequired

Expected date of withdrawal (mm/dd/yyyy)

Reason for Withdrawal

Student 3 Information

First Namerequired

Last Namerequired

Current Graderequired

School Yearrequired

Expected Date for Withdrawal (mm/dd/yyyy)

Reason for Withdrawal

Student 4 Information

First Namerequired

Last Namerequired

Current Graderequired

School Yearrequired

Expected Date for Withdrawal (mm/dd/yyyy)

Reason for Withdrawal

Student 5 Information

First Namerequired

Last Namerequired

Current Graderequired

School Yearrequired

Expected Date for Withdrawal (mm/dd/yyyy)

Reason for Withdrawal

Student 6 Information

First Namerequired

Last Namerequired

Current Graderequired

School Yearrequired

Expected Date for Withdrawal (mm/dd/yyyy)

Reason for Withdrawal

Authorization*

Please check this box to authorize The American Community School of Amman to withdraw the student(s) listed above from ACS.

Parent/Legal Guardian Signaturerequired

Daterequired (mm/dd/yyyy)

Email Addressrequired

Please send a confirmation email to the address below*:

Please provide an email address where we can send a link to your current form.

Email Address :