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COURSE WITHDRAWAL FORM
IT Support
2020-03-25T20:27:13+00:00
High School Course Extension Form
Student Details
Student Name
*
First
Last
Email Address
*
Phone Number
Course Details
Please note: You will need to fill out this form for each course that you would like to extend.
Course Name
*
Course Teacher
*
Course Teacher
Kevin Bernhardt
Jocelyne Bowman
Stacy DeVries
Carmen Howe
Hailey Kennedy
Skye Sperling
Amanda Terpstra
Henderson Tran
Karlena Wieler
Course Activation Date
*
DD slash MM slash YYYY
Reason for Extension
*
Please specify the reason you were unable to complete this course:
Health
Too Busy
Unforeseen Circumstances
Not Motivated
Other
Plan for Completion of the Course
Course Completion Plan
Please outline your weekly plan for the next 3 months that will enable you to complete the course.
Agreement
Agreement
*
I understand that I have to pay a non-refundable tuition of $150 for this extension, and when this form is completed successfully, I will have an additional 3 months added to the course term. I understand that if I do not complete this course in the allotted term, I will be withdrawn from this course. Once Withdrawn I will no longer be able to complete this course and will have to be re-enrolled and start the course from the beginning.
Starting in the 2023/24 school year Students will have up to 10 months to complete a course. If they do not, they can apply for a 2-month extension. The cost of the extension is a $100 tuition and allows us to pay for the teacher’s time for up to the end of the remaining 2-month term.
Yes, I agree to the terms listed above
No, I do not agree to the terms listed above
Signature
*
Please type your full legal name to the above statement. Typed names suffice as handwritten signatures.
Extension Approval (Office Use)
Principal
Signature and Date
To Accounting
Signature and Date
To Records
Signature and Date
Payment Received
Signature and Date
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