Hanako Yamada
6F J-6 Bldg., 6-19-13 Jingumae
Shibuya-ku Tokyo 150-0013
Japan

Oct. 28, 2021　←手紙を書いた日付

↓相手の学校（Admission Office）の住所
Office of Admission
Central Community College
1234 College Road
Los Angeles, CA 95823
U.S.A.

Dear Sir or Madam,　←担当者（名前が分かっている場合はMr. / Ms. xxx）

↓本文
I am writing in regard to the acceptance letter that I received from your school for the Sociology Department.
Application number: 20071029

Unfortunately, I have decided to enroll another institution, and will be unable to enroll your program this time. Thus, I have to withdraw my application to your university. Thank you very much for your consideration.

Yours faithfully,

↓自筆で署名
Hanako Yamada