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

Date of Birth*

Answer Required

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

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

Yes

Parent/Guardian Full Name*

Answer Required

Street Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

I am transferring my scholar to:*

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

Answer Required

Date to enroll at new school*

Answer Required

Best contact phone number*

Number Required

Reason for leaving The ASK Academy*

Select all that apply

Answer Required

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

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

Answer Required

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

Please fix the highlighted areas below before submitting.

The ASK Academy Withdrawal Form