HSA Drop Form

indicates a required answer

HOME SCHOOL ACADEMY DROP REQUEST FORM

1. *	Date

2. *	Student Name

3. *	Grade Level

4.	Please list any courses that are to be DROPPED:

Please list any courses that are to be ADDED (include course name and period of day if repeated course):

* Please note: By filling out this form, you are not guaranteed to be able to add the class(es) you want. We will need to check class size limits and will notify you if the added class has been approved.

6. *

I understand that there is a $5 fee per class to switch classes after the registration deadline.

If my child is dropping a class entirely without taking another class during the same period, there is a $30 drop fee per class.

If my child is a full day student who is no longer going to participate in HSA, the drop fee is $100; in this case, teacher signatures are not required.

All charges will be assessed based on the date this form is received.

Please chose one of the options below.

Drop fees will be waived for first time students who chose the trial period, but class fees will still be due until the drop date.

(1 required)

$5 fee per switched class		agreed
$30 fee per class dropped		agreed
$100 HSA Drop out fee		agreed
I asked for a trial period on my registration		I am working with the registrar on this change.

7. *	Parent Signature (Type your full name for electronic signature):

8. *	Email:

9.	Message to Registrar (optional):

Drop/Add Form

Drop/Add Form

HSA Drop Form