The Withdraw form will be unavailable during Winter Break(Dec. 15th, 2023 - Jan. 5th, 2024). The form will reopen Friday Jan. 5th, 2024 .
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Who is requesting the withdrawal?*field type radio button
Who is requesting the withdrawal?Parent/GuardianEligible StudentAdministrator/Campus Clerk
GISD Administration is submitting this form on behalf of the parent/student because they could not be contacted.

Student Information

	Student ID*field type single line	Date of Birth*field type date	First Name*field type single line	Last Name*field type single line	Grade*field type single line	Current Campus*field type single line	Campus IDfield type single line
row 1	Student ID*field type single line Input blocked. Maximum character limit of 6 characters reached.	Date of Birth*field type date	First Name*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Last Name*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Grade*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Current Campus*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Campus IDfield type single line Input blocked. Maximum character limit of 4000 characters reached.

Parent/Guardian Information:

First Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Last Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Street Address*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
City*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
State*field type single line
Input blocked. Maximum character limit of 2 characters reached.
Zip Code*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Preferred Phone Number:*field type single line
555-555-5555
Input blocked. Maximum character limit of 4000 characters reached.
Preferred Email Address*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Legal Identification*field type file upload
You have reached the maximum file limit: 2.

Withdrawal Information:

Last day student will attend GISD:*field type date
Will the student be moving to a new address?*field type radio button
Will the student be moving to a new address?YesNo

New Home Address:

Street Address*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
City*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
State*field type single line
Input blocked. Maximum character limit of 2 characters reached.
Zip Code*field type single line
Input blocked. Maximum character limit of 4000 characters reached.

Acceptance & Digital Signature

I authorize Garland ISD to accept all correspondence transmitted by me via electronic means. In addition, I certify that all communication sent from this transaction shall be upon my electronic signature and acceptable as replacement for my written signature. I understand that the electronic signature may not be denied legal effect or enforceability solely because it is in electronic form.
By clicking "Accept" below I am certifying that I have read, understand, and agree to the conditions as stated and further agree to conduct business with use of an electronic signature (typed/keypunch name in designated areas).
I have read and understand in full the information contained in this document. By entering my name, checking the box, and clicking the submit button below, I am providing my electronic signature which indicates my confirmation of agreement to the above terms and that all submitted information is accurate and true.

	Date*field type date	First and Last Name*field type single line	Accept*field type checkbox
row 1	Date*field type date	First and Last Name*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Accept*field type checkbox AcceptAccept

Office Use Only

Select withdraw code*field type radio button
Select withdraw code98 - Unknown (temporary status)01 - Student Graduated03 - Student Died19 - Failed required state testing20 - Due to Medical Situation-contact Attendance Department22 - Pursuing GED24 - College-Work towards Degree31 - Received GED46 - Below compulsory attendance age47 - Does not qualify for Pre-K64 - Received GED/Return/Withdraw66 - Student removed by CPS78 - Expelled under 37.00783 - Not GISD Resident-contact Attendance Department84 - Over 19 w/poor attendance85 - Graduated outside of TX86 - Received GED outside TX87 - TX Tech or UT Diploma89 - Incarcerated as adult-contact Attendance Department88 - Attend court-ordered GED program90 - Graduate outside TX under ICEOMC08/16/60 - Document Received(Pregnant/Return to Home Country/Homeschool)80/81/82/CH-Document Received(TX public school/TX private school/School outside TX/Charter School)
Verification of Enrollment*field type file upload
You have reached the maximum file limit: 2.
Verification of Temporary Statusfield type file upload
You have reached the maximum file limit: .
Verification of Student Deathfield type file upload
You have reached the maximum file limit: 2.
Verification of non-qualification for Pre-Kfield type file upload
You have reached the maximum file limit: 2.
Verification of non-Texas graduatefield type file upload
You have reached the maximum file limit: 2.
Verification of TX Tech or UT Diplomafield type file upload
You have reached the maximum file limit: 2.
Verification of Attend court-ordered GED programfield type file upload
You have reached the maximum file limit: 2.
Verification of Failed Required State Testingfield type file upload
You have reached the maximum file limit: 2.
Verification of College-Work towards Degreefield type file upload
You have reached the maximum file limit: 2.
Verification of Compulsory Attendance Agefield type file upload
You have reached the maximum file limit: 2.
Verification of Received GED/Return/Withdrawfield type file upload
You have reached the maximum file limit: 2.
Verification of Expelled under 37.007field type file upload
You have reached the maximum file limit: 2.
Verification of Received GED outside TXfield type file upload
You have reached the maximum file limit: 2.
Verification of Graduate outside TX under ICEOMCfield type file upload
You have reached the maximum file limit: 2.
Must input Graduation Date:*field type date
Student (age 16 with court order, age 17 with parent permission) age 18 or over who is withdrawing to pursue a GED; creates a drop-out if GED is not obtained.*field type file upload
You have reached the maximum file limit: 2.
Submit photo/document if required by age
Must input GED Certificate Number*field type number
By law, school districts must document the withdrawal of students and maintain on file the appropriate paperwork associated with student withdrawals. District withdrawal documentation shall be considered incomplete without a date, official signature(s), and destination of the student. Specific documentation is required by the state when students are removed from a campus by a Child Protective Services Officer.
GISD and State Requirements Include:
A copy of the badge/business card of the CPS Officer:*field type file upload
You have reached the maximum file limit: 2.
A copy of any official order pertaining to the custody of the student:*field type file upload
You have reached the maximum file limit: 2.
A completed and signed Child Protective Services Student Removal Form:*field type file upload
You have reached the maximum file limit: 2.
Information added to the Skyward Entry/Withdrawal Notes record for the student
Overage student (19 or older) who is withdrawn by ADMINISTRATION due to poor attendance. 10 or more unexcused absences in a semester after a warning letter; creates a drop out. Must include the name of the administrator that approved withdrawal.*field type single line
Enter name of Administrator
Input blocked. Maximum character limit of 4000 characters reached.
When the Garland Independent School district becomes aware of a student that is incarcerated in a state jail or federal penitentiary as an adult or as a person certified to stand trial as an adult, the district must have acceptable written documentation to use withdrawal code 89.
First Date of Incarceration:*field type date
Location of Incarceration:*field type single line
Input blocked. Maximum character limit of 4000 characters reached.

Law Enforcement Officer's Information:

	First Name*field type single line	Last Name*field type single line	Phone Numberfield type single line	Email Addressfield type single line
row 1	First Name*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Last Name*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Phone Numberfield type single line Input blocked. Maximum character limit of 4000 characters reached.	Email Addressfield type single line Input blocked. Maximum character limit of 4000 characters reached.

Per board policy, when a student has 10 consecutive days of absence and a “good faith” effort has been made to locate the student, the student may be withdrawn with a code 83. A good faith effort means attempting to call all numbers listed in Skyward and possibly attempting a home visit. If a home visit is attempted before 10 days and a determination is made that the student does not live at the address, the student may be withdrawn at the time the determination is made.
If the campus suspects that a student does not live at the listed Garland/Rowlett/Sachse address, the parent is asked and fails to provide a new, valid proof of residence, the student may be withdrawn at the end of the current semester. If the campus determines that the student does not live at the address via a home visit and did not live at the address at the start of the semester, the student may be withdrawn immediately. I agree that the campus has made a good faith effort to locate the student.
*field type checkbox
I Agree
Assurance Documentsfield type file upload
You have reached the maximum file limit: 2.
Assistant Principal Signature
Date*field type date First and Last Name*field type single line
row 1 Date*field type date
First and Last Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Add

	Date*field type date	First and Last Name*field type single line
row 1	Date*field type date	First and Last Name*field type single line Input blocked. Maximum character limit of 4000 characters reached.

Hidden Fields

After Jan. 24t3. 2024. Please use this link to access the new updated Withdrawal form.
Link : https://ecmdocuments.garlandisd.net/Forms/WithdrawRequest4Testing

Campus AP

	CampusID*field type single line	EmployeeID*field type single line	First Name*field type single line	Last Name*field type single line	Email Addressfield type single line	AD Accountfield type single line	Positionfield type single line	APBackup IDfield type single line
row 1	CampusID*field type single line Input blocked. Maximum character limit of 4000 characters reached.	EmployeeID*field type single line Input blocked. Maximum character limit of 4000 characters reached.	First Name*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Last Name*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Email Addressfield type single line Input blocked. Maximum character limit of 4000 characters reached.	AD Accountfield type single line Input blocked. Maximum character limit of 4000 characters reached.	Positionfield type single line Input blocked. Maximum character limit of 4000 characters reached.	APBackup IDfield type single line Input blocked. Maximum character limit of 4000 characters reached.

Campus AP

	First Namefield type single line	Last Namefield type single line	Email Addressfield type single line	AD Accountfield type single line
row 1	First Namefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Last Namefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Email Addressfield type single line Input blocked. Maximum character limit of 4000 characters reached.	AD Accountfield type single line Input blocked. Maximum character limit of 4000 characters reached.

Campus Data Clerk

	Campus ID*field type single line	First Name*field type single line	Last Name*field type single line	Email Address*field type single line	AD Account*field type single line	Phonefield type single line
row 1	Campus ID*field type single line Input blocked. Maximum character limit of 4000 characters reached.	First Name*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Last Name*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Email Address*field type single line Input blocked. Maximum character limit of 4000 characters reached.	AD Account*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Phonefield type single line Input blocked. Maximum character limit of 4000 characters reached.

Form Submitted
CampusTypefield type single line
For Summer approvals
Input blocked. Maximum character limit of 4000 characters reached.
SummerTeamfield type single line
For summer approvals
Input blocked. Maximum character limit of 4000 characters reached.
Current Stepfield type single line
Input blocked. Maximum character limit of 4000 characters reached.
Campus Typefield type single line
Input blocked. Maximum character limit of 4000 characters reached.
Campus Namefield type single line
Input blocked. Maximum character limit of 4000 characters reached.
CampusIDfield type single line
Input blocked. Maximum character limit of 4000 characters reached.
StuTypefield type single line
for reporting purposes only
Input blocked. Maximum character limit of 4000 characters reached.
Is Date 5/30/23field type single line
Input blocked. Maximum character limit of 4000 characters reached.
CurrentDatefield type date
Is Date 6/8/23field type single line
Input blocked. Maximum character limit of 4000 characters reached.

Request for Student Withdrawal

Student Information

Parent/Guardian Information:

Withdrawal Information:

New Home Address:

Acceptance & Digital Signature

Office Use Only

Law Enforcement Officer's Information:

Assistant Principal Signature

Hidden Fields

Campus AP

Campus AP

Campus Data Clerk