The ASK Academy Withdrawal Form

Please complete the form below . Required fields marked with an asterisk *

One entry per scholar.

Scholar Full Name*

First, Middle, and Last

Answer required for "Scholar Full Name"

Date of Birth*

Answer required for "Date of Birth"

Do you currently have an ASK laptop or Google Chromebook?*

If yes, please email Janisse Vazquez at [email protected], to make arrangements for its return or you will incur a fee of up to $700.00 and the official transcript will be withheld until all fees are paid.

Answer required for "Do you currently have an ASK laptop or Google Chromebook?"

Yes

Do you have any school books? For example: Biology, World History ...*

If yes, please email Janisse Vazquez, [email protected], to make arrangements for its return or you will incur a fee of up to $250.00 and the official transcript will be withheld until all fees are paid.

Answer required for "Do you have any school books? For example: Biology, World History ..."

Yes

Parent/Guardian Full Name*

Answer required for "Parent/Guardian Full Name"

Street Address*

Answer required for "Street Address"

City*

Answer required for "City"

Zip/Postal*

Answer required for "Zip/Postal"

I am transferring my scholar to:*

Enter the name of the school, city, state of transferring school

Answer required for "I am transferring my scholar to:"

Date to enroll at new school*

Answer required for "Date to enroll at new school"

Best contact phone number*

Number Required

Reason for leaving The ASK Academy*

Select all that apply

Answer required for "Reason for leaving The ASK Academy"

Relocation

Academic Rigor (Please explain below)

Limited Academic Options

Lack of Transportation

Lack of credits to graduate

Limited organized sports/activities

School schedule

Other:

What were the two most positive aspects of your experience at ASK?*

Answer required for "What were the two most positive aspects of your experience at ASK?"

What top two things about ASK do you believe could be better?*

Answer required for "What top two things about ASK do you believe could be better?"

Please rate your overall ASK experience.*

On a scale of 1 - 5, with 1 being disappointing and 5 being exceptional

Answer required for "Please rate your overall ASK experience."

The ASK Academy is also interested in direct feedback from your scholar. If your scholar is interested in providing feedback, they may do so at the following link: https://www.theaskacademy.org/apps/form/form.THEAA.sXx3ysR.2rS

By electronically signing this form, I acknowledge that I understand the purpose and intended use by The ASK Academy. I acknowledge that it is my responsibility to read and comprehend the information contained in this form and to consult with The ASK Academy if I have any questions concerning its contents.*

Parent/Guardian Signature

Answer required for "By electronically signing this form, I acknowledge that I understand the purpose and intended use by The ASK Academy. I acknowledge that it is my responsibility to read and comprehend the information contained in this form and to consult with The ASK Academy if I have any questions concerning its contents."

Please fix the highlighted areas below before submitting.

The ASK Academy Withdrawal Form