PCS: Exit form

Thank you for taking a few minutes to fill out and return this form. Your feedback is very important to us. We value the members of our PCS community and seek to serve PCS students and their families in the best way possible; the information you provide will be used for that purpose.”

Student name

Last nameFirst Name

Student's Current Grade

Name of school student is transferring to:

Last Date of Enrollment at PCS*

Date

To what extend were each of the following factors in your decision to leave PCS?

Rows	Not a factor at all	somewhat of a factor in decision	factored into the decision	highly relevant factor in decision to leave
Lack of Support and communication from teachers
Homework load too heavy
Academics too difficult
Too many AP classes required
Stress level too high for student
Concern about GPA for college admission
Commute distance to school too far
Lack of flexibility in class choices
Lack of choices of sports
Lack of social connection
Financial donation request
Parent volunteer hour request
Lack of diversity( student diversity, ethic, or socio-economic)
Not on track to graduate

Other (please specify)

PCS is not a good fit because

Please use the space below to give us any comments or suggestions that you may feel benefit PCS students and families.

Parent Email

example@example.com

Parent Name

First NameLast Name

Would you be willing to be contacted by PCS for more clarity regarding your decision to leave?

YesNo

If the answer above was Yes, please provide your preferred contact phone number or email