Please Fill Out The Student Residency Form Below
Reaquired field: Student Name
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Reaquired field: Date of Birth
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Reaquired field: Person completing this form
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Reaquired field: Relation to Student
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Reaquired field: Phone Number:
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Reaquired field: Current Address:
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Reaquired field: City, State, Zip
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Reaquired field: How Long at this address?
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If you answered NO to ALL questions, please sign and date below. Submit form to school personnel by clicking SEND at the bottom of the page.
Parent Signature
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If you answered YES to ANY question above, please complete the remainder of this form.
Please add more information for questions 1-3.
If you selected option #1, how many bedrooms? How many people?
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If you selected option #2, name of motel?
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If you selected option #3, name of agency?
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Please list all children (under 21 y/o) currently living with you, including those not yet old enough for school enrollment.
Name of Student
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Realtionship to Student
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Date of Birth
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Grade
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School Name
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Name of Student
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Realtionship to Student
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Date of Birth
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Grade
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School Name
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Name of Student
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Realtionship to Student
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Date of Birth
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Grade
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School Name
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Name of Student
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Relationship to Student
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Date of Birth
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Grade
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School Name
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By typing your name below, you agree to the following: * I certify that the information provided above is correct and accurate.
Signature
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Send
Required Fields