* 1. Student Name: Last, First

* 2. Grade

* 3. School

* 4. Last Date Attended

* 5. Number of years your student attended MTSD

* 6. Why are you leaving the Mequon-Thiensville School District?

* 7. What did you enjoy most about the Mequon-Thiensville School District?

* 8. What should the district focus its continuous improvement efforts on in order to improve service?

* 9. On a scale of 1-5, how would you rate your overall experience in MTSD?

* 10. Additional comments or feedback:

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