Student Permanent WithdrawalMCPS Form 5654 Page 1 of 2 July 2017Office of the Chief Academic Officer Office of Student and Family Support and Engagement Maryland State Department of Education MONTGOMERY.

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How to fill out the MD Montgomery County Public Schools Form 565-4 online

Filling out the MD Montgomery County Public Schools Form 565-4 is an essential process for documenting a student's permanent withdrawal from school. This guide provides clear, step-by-step instructions tailored to help users navigate the online completion of this form accurately.

Follow the steps to successfully complete Form 565-4 online

  1. Click ‘Get Form’ button to access the form and open it in your editor. This action will allow you to start filling out the necessary fields online.
  2. In Part I, enter the student's information accurately. This includes the school year, grade, school name, legal name, and address. Specify where the student resides and their contact details.
  3. Complete the attendance records for both the current year and the previous year. Indicate the student's date of birth, age, and gender.
  4. List the names and relationships of the adults responsible for the student. Ensure to provide their contact information and whether they were present for the interview.
  5. In Part II, if applicable, check the appropriate reason for withdrawal and document key dates for meetings and interventions. Make sure to identify any reasons for failure to contact the student or parent/guardian.
  6. Proceed to Part III and complete the details related to the interview. Input the names and titles of those present and summarize the outcomes of the interview.
  7. In Part IV, enter the relevant withdrawal codes, and ensure all required signatures are obtained from the student, parent/guardian, interviewer, and principal.
  8. Once all sections are filled out, review the form for accuracy. You can then save the changes, download, print, or share the completed form as needed.

Complete your documents online with confidence and ensure the smooth withdrawal process for students.

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