LCA Notice of Withdrawal Please Note: The submission of this form will formally withdraw your student in accordance to the continuous enrollment agreement. See Excerpt below: Withdrawal of Student And Termination of Continuous Enrollment Agreement By Parent or Guardian Parent or Guardian below hereby understands and agrees that this (Continuous Enrollment) Agreement shall renew automatically for each successive academic school year until STUDENT’S graduation from LCA, unless and until this Agreement is terminated by LCA, or the STUDENT’S PARENT submits the LCA Notice of Withdrawal on or before January 31 of the proceeding year for the next academic school year. PARENT understands and agrees that if the STUDENT will not be returning to LCA for the following school year, PARENT is required to submit the LCA Notice of Withdrawal form to the Admissions Office by no later than January 31 of the preceding school year, or the PARENT will be responsible for the tuition and fees as set forth below for the subsequent school year. If this Notice of Withdrawal is received by LCA by January 31 of the preceding school year, the PARENT will be released from paying 100% of the next year’s annual tuition and the STUDENT will be withdrawn at the end of the current school year.Withdrawal School Year* 2019-2020 2020-2021 Please select the school year for which your are withdrawing your student.Parent/Guardian Name* First Last Student Name* First Last Date of Birth* Date Format: MM slash DD slash YYYY Current Student Grade*Please SelectPreK3PreK4Junior KindergartenKindergarten1st2nd3rd4th5th6th7th8th9th10th11th12thWithdrawal Date (Please complete only if your student will be withdrawing prior to May 22, 2020.)Withdrawal Reason* Student will not be attending LCA for 2020-21 school year - date of withdrawal will be last day of school, May 22, 2020 Moving out of Area Financial Academic Other-Please Explain Below Parent Signature*Please note typing your name in the field above serves as your signature that you are the parent or guardian of the student listed above and are authorized to withdraw student from school.