Page 78 - FY21_LawsonAcademy_FacultyHandbook

EXHIBIT B: STUDENT EXIT INTERVIEW FORM

Student Exit Interview

Thank you for completing out Student Exit Interview form. They are important as they assist us
in compiling important information needed to improve student retention and increase our student
enrollment.

Student Information:
Student Name - _______________________________________________________________
Last Name First Name Middle Initial

th
th
th
Current Grade- □ 6 □7 □8

Parent Name - ___________________________Contact Number - ________________________

Email Address- _________________________________________________________________

Please obtain signatures below to ensure students have been cleared:

□ Text Books __________________________________ Date Cleared- ___________________

□ PEIMS _____________________________________ Last Date of Attendance- __________

□Report Card __________________________________Date to be Issued- ________________

Exit Type:

□ Voluntary Withdrawal

□ Relocating outside of Boundaries New ISD- _______________________________

□ Transportation

□ Parent Choice- (Please Explain) _______________________________________________

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