Withdrawal Form

The Withdrawal Form is used when a student is withdrawing from one LEA and moving to another LEA. (TX69)

Selection Criteria

Selection criteria determine which database records are used in the report. For the Withdrawal Form, student records are selected.
Student Selection

Prior to running the report use Student Search to make your current selection the students who need this report.

Report Input

Follow the list of steps to locate and generate the report.

On the Start Page, click State Reports. The Reports page appears.
Click Withdrawal Form. The Withdrawal form report page appears.
Enter information in all of the required fields.
Click Submit to generate the report.

Field	Description
Always use Current Selection	Select the option “The Select x Students Only”
Records Requestor	Select the person who is requesting the withdrawal form.
District Name (if Requestor)	Enter the name of the District requesting the withdrawal form.
School Year	Choose the school year for the student enrollment data to be included in the report. This value populates the school year field within the extract.
Term For grades	Select the marking period of grades to display on the withdrawal form.
Exit Date Override	Enter the withdrawal date if it is different from the Exit date of the student.
Run Now	Select this option if the user wants to run the report immediately.
Schedule	Select this option if the user wants to run this report on a scheduled basis. Once this option is selected the following choices are: Run Once Start Date and Start Time to run the report. Repeat Select Daily, Weekly, Monthly or Yearly for the appropriate re-occurrence for running the report. If Daily is selected, click the Weekdays only box to limit to weekdays. If Weekly is selected, select which weekday to run the report. If Monthly is selected, select the month to run the report. If Yearly is selected, select either the date or the weekday to run the report. Date Range – Select No End Date or a date that the re-occurrence should end.

Report Output: Withdrawal Form Report [pdf]

Each of the fields displayed in the output of the report are described below. See Understanding the Report Output Table for a definition of each column in the table.

Data Element	Description
District Name	District Name
School Name	School Name
School ID	School ID
School Phone Number	School Phone Number
Name	Name of the student
Suffix	Generation Code for the student
Date of Birth	Date of Birth
Gender	Gender
State Student Number	State Student Number
SSN/State Approved Alt ID	SSN/State Approved Alt ID
ID last reported to PEIMS	Noted if a student changed from a state number to SSN
Local Student ID	Student Number
Newest Entry Date	Latest entry date from students
Last Withdrawal Date	Withdrawal date from enrollment or entered from the report options
Placed in grade	Identifies if the student was placed in a grade
Promoted to Grade	Identifies if the stuent was promoted to a grade
Current Grade Level	Current Grade Level
Ethnicity	Identifies the scheduling ethnicity
Hispanic	Identifies if the student is Hispanic/Latino
Race	Identifies the federal races for the student
Home Language	Identifies the student’s home language
Bilingual	Identifies if the student is in the bilingual program.
ESL	Identifies if the student is in the ESL program.
Gifted	Identifies if the student is in the gifted and talented program.
LEP	Identifies if the student is in the LEP program
Special Education	Identifies if the student is in the special education program.
Title I	Identifies if the student is in the Title I program.
Free/Reduced Lunch	Identifies the student’s economically disadvantaged status.
Migrant	Identifies if the student is in the Migrant program.
Schooling: Texas School, Home School, Private School, Out of State	Identifies if the student is transferring to another Texas school, home school, private school or out of state school.
Current Grades	Identifies the grades for each class at the time of withdrawal. The grades displayed are based on the report option selected at the time the report is run. For attendance to be reported once per absence when the section spans multiple periods on the same date the following setup is required: The Section must be coded for Attendance to be taken Once for All Meetings. In System > Quick Lookup Preferences the setting must be checked for Count Multi-Period Meeting attendance once per day.
Signatures	Signatures of the particular administrators and parents affirming the information on the form.