Family Form

Child Care Withdrawal Notice

Complete the notice below, review the completed PDF, and confirm that the information is correct before sending it to Strawberry Vale OSC.

One calendar month's notice: withdrawal takes effect on the last working day of the month. Complete the form below, review the completed PDF, and confirm that you want to send it.

Parent/Guardian full name

Parent/Guardian email

Child full name

Effective withdrawal date

Reason for withdrawal (optional)

This information is for statistical reasons only.0/180 characters

Optional feedback

How has your child or family benefited from his/her experience at this Centre?

0/240 characters

In what ways could we improve the program to better meet your child's or family's needs?

0/240 characters

Parent/Guardian electronic signature

Type your legal name as your electronic signature.

Signature date

Review before sending

Create the completed PDF, open it, and check that the names, date, and optional answers are correct. The final confirmation box is required before the notice can be sent.

Human verification (required)