Student Withdrawal Request for 2023-2024

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Please note that only parents or guardians listed in our databases can withdraw students. By completing and submitting this form, you are requesting for Chamblee Middle to withdraw your child from Chamblee Middle to attend another school either in the DeKalb County School District or another school system. Please complete all fields below and allow 24-48 hours processing time for your request.

Student's Last Name *

Student's First Name *

Student's Middle Name *

Student's Grade Level for 2023-2024 School Year *

Do you have a chrome book you need to return? (All chrome book returns will be verified prior to release of records) *

Yes (I need to schedule an appointment to drop off and will email registrar asking for next available time)

Parent's Last Name *

Parent's First Name *

Parent's Email *

Parent's Phone Number (###-###-####) *

Student's New Address (Street,City, State, Zip) *

Name of New School for 2023-2024 *

Address of New School for 2022-2023 (Street, City, State, Zip) *

Reason for Withdrawal: *

Date of Withdrawal Request *

YYYY

I have emailed a copy of my ID (driver's license, passport, visa) to the school's registrar. *

I certify that I am the student's legal parent/guardian and give Chamblee Middle School my permission to withdraw my child for the 2023-2024 school year to attend anther school. I understand that all records will be held until textbooks, chrome books, and other school items are returned. It is my responsibility to make sure these items are returned to the school. I have contacted the school to request a date to return all items in my possession. *

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