THIS FORM MUST BE COMPLETED BY THE PARENT/GUARDIAN OR PERSON IN PARENTAL RELATIONSHIP.

Intent to Unenroll to Attend Private School

This form is for students who still live in the South Huntington School District, but are leaving to attend a private school.

Please fill out a separate line for each enrolled student that you would like to unenroll from the South Huntington Union Free School District. If you require more space, please submit a second form.

Today's Date *

Student 1:

Student's Last Name: *

Student's First Name: *

School Enrolled: * 🛈

Name of New School or District: *

Last Day of School: * +

Student 2:

Student's Last Name:

Student's First Name:

School Enrolled: 🛈

Name of New School or District:

Last Day of School: +

Student 3:

Student's Last Name:

Student's First Name:

School Enrolled: 🛈

Name of New School or District:

Last Day of School: +

Student 4:

Student's Last Name:

Student's First Name:

School Enrolled: 🛈

Name of New School or District:

Last Day of School: +

Student 5:

Student's Last Name:

Student's First Name:

School Enrolled: 🛈

Last Day of School: +

Print First and Last Name of Person Completing Form: *

Your relationship to the student(s)? *

Please enter your email: 🛈

Please enter your phone number: *

Signature: *

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