FormsParents & StudentsEnrollment/Records → Educational Interview for Withdrawal Prevention

Educational Interview for Withdrawal Prevention

About this Form

Form number: 565-4a

Audience:  School Staff

Last revised: June 2017

Related Forms

Form 565-4 - Student Permanent Withdrawal

Introduction: The purpose of the interview is to encourage the student to remain in their current/or other appropriate MCPS program. This interview is a counseling tool and an intervening process that may serve to enhance the student’s decision making. Additionally, it provides another means of reaffirming the school’s interest in the student and asserting the school’s continued willingness to be an ongoing resource to support the student. See MCPS Regulation JEC-RA, Student Withdrawals from Classes and School.

Directions: This form should be completed by the school counselor, pupil personnel worker (PPW), or a school administrator prior to completing MCPS Form 565-4,Student Permanent Withdrawal. 

Adobe PDF Educational Interview for Withdrawal Prevention152 KEnglish
Adobe PDF Entrevista Educacional para la Prevención del Abandono de Estudios39 KSpanish
Adobe PDF Entretien Scolaire pour la Prévention des Retraits40 KFrench
Adobe PDF Cuộc Phỏng Vấn Giáo Khoa để Ngăn Ngừa Việc Bỏ Học110 KVietnamese
Adobe PDF 退學干預教育面談212 KChinese
Adobe PDF 자퇴 예방을 위한 교육용 인터뷰75 KKorean
Adobe PDF ስለ ተማሪ ከት/ቤት በግል መገለልን ለመከላከል ትምህርታዊ ቃለመጠይቅ65 KAmharic

Forms require Adobe Acrobat Reader 8 or higher. Get Acrobat