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Vital Academy Leading the next generation to Worship God, Find Freedom, Discover Purpose and Make a Difference! Monthly Events and Activities Optional Umbrella Covering Strong Support Community Christ-centered Co-op for Pre-K - 12th Grade
 

Vital Academy Umbrella Covering Withdrawal

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Please complete this form if your student has been covered under Vital Academy's umbrella covering and you wish to withdraw them from this covering. You have the option to continue your membership in our support group only. 
1. *

TODAY'S DATE: 
2. *

PARENT FIRST AND LAST NAME:
3. *

STUDENT FIRST AND LAST NAME:
4. *

STUDENT GRADE LEVEL:
5. *

PLEASE WITHDRAW MY STUDENT FROM:
6. *

EFFECTIVE DATE OF WITHDRAWAL: 
7. *

DO YOU APPROVE VITAL ACADEMY TO RELEASE ANY AND ALL RECORDS TO A SCHOOL YOUR STUDENT IS MOVING TO SHOULD THEY CONTACT US REQUESTING THIS INFORMATION? 

 
8. *

EMAIL: 
9. *

I understand that Vital Academy cannot release my student's records until all attendance has been submitted. I agree to submit all attendance thus far. 
Yes I am unable to submit attendance.
10. *

PARENT SIGNATURE:

If you are enrolling your student in another umbrella school, private school or public school; their office can send their records request form to [email protected]. If you are moving your student to homeschool through your county, you will need to submit your Letter of Intent to your county homeschool office. If you need anything else, don't hesitate to reach out. Thank you for being with Vital Academy and we wish you the very best on your next steps!