Project MEGSSS Withdrawal Notice

Project MEGSSS Withdrawal Notice
Student Name

First NameLast Name
E-mail
Main Contact Phone Number

Area CodePhone Number
My student is a:
Please state the general reason for your student's withdrawal:
Does your student plan to complete the semester final (If applicable)?
Have you consulted with the MEGSSS Academic Director?
Would you like to be contacted by a staff member to discuss this change of status?
Parents' Acknowledgement of Financial Responsibility:
I am withdrawing my child from Project MEGSSS. I have read the policies published online at www.MEGSSS.org concerning Withdrawal, have contacted the office concerning any fees due for the current semester (or summer), and agree to pay any balance due and payable to Project MEGSSS. I understand that withdrawal will become effective when all fees owed are paid, or there is a plan in place to complete payment of all fees due.
Please type your name here indicating agreement with the above statement.
Should be Empty:

Parents' Acknowledgement of Financial Responsibility: