HomeMy WebLinkAboutOCDSB 190 Student Withdrawal Form
OCDSB STUDENT WITHDRAWAL FORM
Instructions for Completing the OCDSB Student Withdrawal Form
The attached form may be used by school staff to facilitate accurate data collection and reporting for students who withdraw
(i.e., are demitted) from an OCDSB school and who are not transferring to another school within this board. It is recommended
that completed forms be stored in the Audit Box at the school.
Section 1 – Student Information
Information in this section should be completed using information from Trillium.
Section 2 – Demit Code
The demit codes listed in this section of the form are to be used by elementary and secondary schools in the OCDSB (Note:
While there are additional demit codes available within Trillium, they are reserved primarily for use by the Adult H.S.).
The demit code selected should reflect the “destination” of the student (i.e., where he/she indicates they are going once they
withdraw from your school), regardless of whether or not the student has earned a certificate/diploma. These demit codes are
Elementary/Secondary External TransfersRetirements (Post-Secondary Destination Provided)
listed under the and
.
categories on the attached form
In the event that a student indicates they are leaving your school to attend school in another board, the first option of choice in
Elementary/Secondary External Transfers
the category should be “Other Board”. Note that if this option is selected, you will
be prompted to enter the BSID for the “receiving” school. If the BSID is not recognized in Trillium for the receiving school,
“Other Ed.-Ont.” should be selected.
Retirements (No Destination Provided)
When the “destination” of the student is not known, an option under the should be
Other
considered. If none of these options are deemed to be appropriate, schools may choose the “Unknown” option in the
category.
Section 3 – Reason for Leaving School
A Reason For Leaving School is required to be entered for all students who are withdrawn/demitted from your school
(including those who are transferring to another school within the board). Only one option can be selected from the drop-down
menu; schools should choose the option that best describes why the student is leaving. Every effort should be made to find out
the reason the student is leaving the school to reduce the need to use the “Unknown” option.
If there is no option available in the drop-down menu that reflects the student’s reason for leaving school, choose “Other” from
the drop-down menu and use the Remarks field in Trillium to describe their reason for leaving. (Note: Schools may also use the
Remarks field to provide additional information regarding student’s Reason for Leaving School. For example, for a student who
indicates that he/she is going to another school/board because their academic needs are not being met, you may wish to provide
specific details regarding the specific program or support that the student is seeking).
Section 4 – Signatures
This section should be completed by school staff responsible for acquiring the information from the student, or parent of the
student, who is being withdrawn. An area to include any additional comments regarding the student’s withdrawal (e.g.,
attempted contacts made to the home to identify why the student is withdrawing from school or where the student intends to go
once they have withdrawn) can be included in this section (Note that this area is intended for school use only).
OCDSB 190 Curriculum (January 2010) Page 1 of 2
OCDSB STUDENT WITHDRAWAL FORM
1. STUDENT INFORMATION
Name: ________________________________________________________ Student ID: ______________________
Home Address: _________________________________________________ Phone: ___________________________
Date of Birth: _____________________________________ Date of Withdrawal: _____________________________
Homeroom or First Period: School:
2. DEMIT CODE Check one option only.
Elementary/Secondary External Transfers Retirements (No Destination Provided)
With Certificate/Diploma:
□
HomeSch
□
Cert. of Accomp.
□
Private School
□
OSSC
□
Other Board (BSID known)
□
OSSD
□
Other Ed.-Ont. (BSID unknown)
Without Certificate/Diploma:
□
Other Province
□
Courts
□
Other Country
□
Expelled
Retirements (Post-Secondary Destination Provided)
□
Limited Expulsion
□
Apprentice.
□
No Diploma/Cert.
□
College
Other
□
University
□
Deceased
□
Employment-ON
□
Unknown
□
Employment-CAN
□
Employment-OTH
3. REASON FOR LEAVING SCHOOL Check the one option that best describes why the student is leaving your
school. Additional information may be entered in the “Remarks” field to provide greater clarity regarding the student’s
reason for leaving school.
□□
Academic/program needs not being met Moving
□□
Daycare arrangements/needs Non-attendance
□□
Earned certificate or diploma Other
□□
Extended travel Social, Emotional, Behavioural
□□
Lacking community service hours Transfer to another school in the OCDSB
□□
Learning environment inadequate Transportation
□□
Medical Unknown
Remarks:
4. SIGNATURES
________________________________________________ __________________________
Principal Signature (or designate) Date
Additional Comments:
Note:Demit CodeReason for LeavingRemarks
Both the and must be entered into Trillium when a student is demitted from an OCDSB school. The
field should be used to provide additional information regarding the student’s reason for leaving.
OCDSB 190 Curriculum (January 2010) Page 2 of 2