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<div class="page-inner">
  <h1>Student Exit Form</h1>
<p>* Required</p>
<hr/>

  
<div class="wpcf7 no-js" id="wpcf7-f3165-o1" lang="en-CA" dir="ltr" data-wpcf7-id="3165">
<div class="screen-reader-response"><p role="status" aria-live="polite" aria-atomic="true"></p> <ul></ul></div>
<form action="/graphql#wpcf7-f3165-o1" method="post" class="wpcf7-form init" aria-label="Contact form" novalidate="novalidate" data-status="init">
<fieldset class="hidden-fields-container"><input type="hidden" name="_wpcf7" value="3165" /><input type="hidden" name="_wpcf7_version" value="6.1.1" /><input type="hidden" name="_wpcf7_locale" value="en_CA" /><input type="hidden" name="_wpcf7_unit_tag" value="wpcf7-f3165-o1" /><input type="hidden" name="_wpcf7_container_post" value="0" /><input type="hidden" name="_wpcf7_posted_data_hash" value="" />
</fieldset>
<style>
.wpcf7 textarea {
 width: 100%;
}
input.wpcf7-text {
 width: 100%;
}
.page-inner {
 padding-bottom:0;
}
.page-inner h1 {
 margin-bottom:0;
}
span.wpcf7-list-item {
 padding: 0 15px 0 0;
}
span.wpcf7-list-item-label {
 padding: 2px 5px 0 5px;
}
span.wpcf7-list-item, span.wpcf7-list-item label, span.wpcf7-list-item-label {
 display: inline-flex;
 align-self: center;
}
</style>
<p><label> Student Name*<br />
<span class="wpcf7-form-control-wrap" data-name="student-name"><input size="40" maxlength="400" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" aria-invalid="false" value="" type="text" name="student-name" /></span> </label>
</p>
<p>Current Grade*<br />
<span class="wpcf7-form-control-wrap" data-name="current-grade"><select class="wpcf7-form-control wpcf7-select" aria-invalid="false" name="current-grade"><option value="Please select...">Please select...</option><option value="Grade 7">Grade 7</option><option value="Grade 8">Grade 8</option><option value="Grade 9">Grade 9</option><option value="Grade 10">Grade 10</option><option value="Grade 11">Grade 11</option><option value="Grade 12">Grade 12</option></select></span>
</p>
<p><label> Name of school of registration for September 2020:*<br />
<span class="wpcf7-form-control-wrap" data-name="name-school-registration"><input size="40" maxlength="400" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" aria-invalid="false" value="" type="text" name="name-school-registration" /></span> </label>
</p>
<p><label> School location/city:*<br />
<span class="wpcf7-form-control-wrap" data-name="school-location"><input size="40" maxlength="400" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" aria-invalid="false" value="" type="text" name="school-location" /></span> </label>
</p>
<p><label> Reason for withdrawing from SMCS:*<br />
<span class="wpcf7-form-control-wrap" data-name="withdraw-reason"><textarea cols="40" rows="10" maxlength="2000" class="wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required" aria-required="true" aria-invalid="false" name="withdraw-reason"></textarea></span> </label>
</p>
<p>Would you like Mr. Fischer or Mr. De Piero to follow up with you with a phone call?*<br />
<span class="wpcf7-form-control-wrap" data-name="follow-up-call"><span class="wpcf7-form-control wpcf7-radio"><span class="wpcf7-list-item first"><label><input type="radio" name="follow-up-call" value="Yes" /><span class="wpcf7-list-item-label">Yes</span></label></span><span class="wpcf7-list-item last"><label><input type="radio" name="follow-up-call" value="No" /><span class="wpcf7-list-item-label">No</span></label></span></span></span>
</p>
<p><input class="wpcf7-form-control wpcf7-submit has-spinner" type="submit" value="Submit" />
</p>
<div class="wpcf7-response-output" aria-hidden="true"></div>
</form>
</div>


</div>

Student Exit Form

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