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DCPS Student Withdrawal Form Guidance The DCPS Student Withdrawal Form was designed to capture the movement of a student when withdrawing from DCPS. Historically students were withdrawn without any documentation regarding neither the reason nor the next school of attendance when applicable. This form will now allow for accurate reporting of student movement to the Office of the State Superintendent of Education and better assist DCPS in adhering to local and federal regulations. questions regarding the form or the Admission and Withdrawal Policy Guide please contact the ODA Help Desk at 202. The Sending School s representative must complete this and indicate the effective date of withdrawal. The effective date of withdrawal is the date in which the Sending School receives the DCPS Student Withdrawal Form back from the receiving school. The Sending School must receive the form back from the receiving school prior to withdrawing the student in DC STARS when applicable. Things to Consider Refer to the Admission and Withdrawal Policy Guide to determine when the DCPS Student Withdrawal Form is required When applicable students should not be withdrawn in DC STARS until the DCPS Student Withdrawal Form is received with all required signatures Section III Receiving School The Receiving School is the school that the parent/guardian or student age 18 has indicated as the next school of attendance. This form will now allow for accurate reporting of student movement to the Office of the State Superintendent of Education and better assist DCPS in adhering to local and federal regulations. questions regarding the form or the Admission and Withdrawal Policy Guide please contact the ODA Help Desk at 202. 442. 9281 or oda*helpdesk dc*gov* Student Demographic This section reflects the student demographic data and attending school information at the time of the withdrawal* The data depicts information captured in DC STARS* Section I Parent/Guardian or Student Age 18 This section should be completed by the student s parent or guardian as reflected in DC STARS* If the student is age 18 then the student can withdraw him/herself from the school* When applicable a next school and location must be indicated when a student is withdrawing. Section II Sending School The Sending School is the school where the student is presently attending. The Receiving School must complete this section and return the form to the sending school before the student can be withdrawn in DC STARS* If the receiving school does not stamp the form with a school stamp then the receiving school must write a letter on school letterhead indicating the enrollment of the student. 1 2 0 0 F i rs t S t r e et NE W a s hi ngt o n D C 2 00 0 2 T 2 0 2. 4 4 2. 58 8 5 F 2 0 2. 44 2. 5 0 2 6 www. questions regarding the form or the Admission and Withdrawal Policy Guide please contact the ODA Help Desk at 202. 442. 9281 or oda*helpdesk dc*gov* Student Demographic This section reflects the student demographic data and attending school information at the time of the withdrawal* The data depicts information captured in DC STARS* Section I Parent/Guardian or Student Age 18 This section should be completed by the student s parent or guardian as reflected in DC STARS* If the student is age 18 then the student can withdraw him/herself from the school* When applicable a next school and location must be indicated when a student is withdrawing.

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