Clearance Form

Student’s Name: ……………………………………………………………………………………………

Leaving Date: …………………………………… Form:………………………

If your clearance form is not returned to Registration Office fully completed on your final
day of school, the school will be unable to release your leaving documentation.

Secondary Students only

Staff Initial Signature Date

Accounts
PE
Science
Library
Registration Office

Primary Students

Staff Initial Signature Date

Accounts
Library
Registration Office