Change of Information Form
Please complete this form to change demographic information (address, phone, e-mail) for your child(ren). ** If you have a change of address, please follow the instructions below to provide proof of new residency. **
Name of person completing this form:
Relationship to student(s)
If you answered other, please explain:
Effective date the change will take place:
Student #1 - Name and Grade Level
Please list the name AND grade level of each student the change(s) will affect:
Student #2 - Name and Grade Level
Student #3 - Name and Grade Level
Student #4 - Name and Grade Level
Address Change - New Address
If you have a change in address, you will need to provide proof of your new address (copy of lease/mortgage agreement, current utility bill, pay stub, tax statement, voter ID, or vehicle registration/drivers license with new address).
How will you be submitting proof of new address?
In person at the Central Office located at 1300 Fifth Street
By FAX at 724-774-8770
Will this change affect bus transportation?
If you answer yes, the District will notify the transportation company.
Telephone Change - Home Phone
Telephone Change - Mother's Cell
Telephone Change - Father's Cell
New E-Mail Address - Mother
New E-Mail Address - Father
If there are demographic or other changes not listed above, please explain.
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This form was created inside of Beaver Area School District.