2014-2015 Student Residency Verification Form

RESIDENCY FORM
______________________
Student Name
2014-2015
Student Residency Verification Form
This section must be completed by parent/guardian:
Name of Student:
Age:
Grade entering in 2014-2015:
DOB:
Parent/Guardian Name:
Address:
Town:
Home Phone:
Cell Phone:
Work Phone:
Email:
The above information is correct and accurate.
Parent/Guardian Signature
Date
This section is to be completed by the School District that the above student resides in:
This verifies that
District.
resides in the
School
Signature of District Official/Residency Officer:
Print Name:
Phone Number:
Date:
[District Stamp Below]
This form must be returned to your magnet school main office.
4.21.2014
Magnet Schools/NewStudentRegistrationForms/RSCOResidency2014
2014-2015
Formulario de Verificación de Residencia del
Estudiante
Esta sección debe ser completada por el padre/tutor legal:
Nombre del estudiante:
Grado que entra en 2014-2015:
Edad:
Fecha de Nacimiento:
Nombre del Padre/Tutor Legal:
Dirección:
Ciudad/Pueblo:
Tel del Hogar:
Tel Celular:
Tel del Trabajo:
Correo Electrónico (Email):
La información anterior es correcta y exacta.
Firma del Padre/Tutor Legal
Fecha
Esta sección debe ser completada por el Distrito Escolar donde reside el estudiante anteriormente
nombrado (This section is to be completed by the School District that the above student resides in):
This verifies that
District.
resides in the
School
Signature of District Official/Residency Officer:
Print Name:
Phone Number:
Date:
[District Stamp Below]
4.21.2014
Magnet Schools/NewStudentRegistrationForms/RSCOResidency2014