* Required

1. Withdrawing Student(s) Name and Grade(s)

2. Parent(s) Name:  (full name)

3. How long has your family been a part of the NIS community?

4. When is your child's last day of school?  (estimated)

5. Forwarding Address: Please indicate your new postal mailing address here  (the family address)

6. Email Address: If you have a new email address that you prefer for us to use for contacting you via email, please submit that here:

7. New School Information: If known, please share details (name, location, etc.) of your child’s next school:

8. Which of the following explains your reasons why you wish to withdraw your child from NIS?  (You may check more than one option)

9. Please rate our success in the following areas:

10. Please tell us what you believe we can do to improve NIS

11. Is there an significant or impactful interaction or relationship between either your family or your child and a member of the NIS faculty, administration or staff?   (Please share or recognize that person here.)

12. Yearbook:  Students who are withdrawing and leaving Japan prior to June 1 need to indicate whether a yearbook should be forwarded or not. Please note that if you choose "Yes", you will need to complete a postage label with your forwarding address, and submit it to the Academic Office before the withdrawal date or May 31, whichever is earlier. Yearbooks are typically sent via postal mail, or available for collection, in June.

13. Is there anything else that you would like us to know about your time here at NIS?

14. Would you be interested in being an NIS Ambassador Parent?  We always need parent advocates for the school even after leaving Nakashidami! Knowing this would help so that we can possibly connect families with past (or future!) alumni in your area or with a family who may be considering NIS)

Thank you very much!