2018-2019

ST. GEORGE MUNICIPAL SCHOOL UNIT

PROOF OF RESIDENCY FORM

Full name and age of student(s) for whom this form is being presented:

1. ____________________________________________________age_______18-19 grade_______

2. ____________________________________________________age_______18-19 grade_______

3. ____________________________________________________age_______18-19 grade_______

4.  ___________________________________________________age_______18-19 grade_______

Name and address for all parents and/or legal guardians.  Please include full name, mailing address, physical address, e-mail, and best phone for all.  

Name: ________________________________________________________________________

Relation: ______________________________________________________________________

Mailing Address: _______________________________________________________________

Physical Address: _______________________________________________________________

Email: ________________________________________________________________________

Phone: _______________________________________________________________________

Name: ________________________________________________________________________

Relation: ______________________________________________________________________

Mailing Address: _______________________________________________________________

Physical Address: _______________________________________________________________

Email: ________________________________________________________________________

Phone: _______________________________________________________________________

Name: ________________________________________________________________________

Relation: ______________________________________________________________________

Mailing Address: _______________________________________________________________

Physical Address: _______________________________________________________________

Email: ________________________________________________________________________

Phone: _______________________________________________________________________

With whom, and what percentage of time with this parent(s) or guardian, does the student reside in St. George? ________________________________________________________________

OVER

Because it is essential that the Superintendent be able to confirm that the student and the student’s parent(s) or guardian is a resident of the Town of St. George, you need to bring some documentation with you to demonstrate residency when you have this form signed by a Town Official.  The following are common forms of documentation that can be used to demonstrate residency:

  1. A current, valid driver’s license with a St. George address;
  2. Confirmation of St. George voter registration;
  3. A St. George Homestead Exemption;
  4. The mailing address on your most recent State or Federal Tax return indicating St. George;
  5. A court order awarding parental rights and responsibilities and specifying the child’s primary residence.

In addition, for students who have one parent/guardian who resides in the Town of St. George and one who resides somewhere other than St. George, please attach a copy of the agreement or court order that is currently in effect or other documentation that can confirm the student’s legal residence.  Legal residence means that place in which a person’s habitation is fixed and to which that person, whenever absent, has the intention to return. A person can only have one legal residence at any given time.

PLEASE ATTACH COPIES OF PROOF OF RESIDENCY DOCUMENTS

TO THIS RESIDENCY FORM

I certify that the information contained herein is true and correct and that 1) I actually live with the student named above in the Town of St. George at the above address; 2) that we will actually live there during the school year; and 3) that I am not residing in any other place, or claiming residency in any other place for any purpose or for any other student for the purpose of school enrollment or tuition, for this school year.  Also, 4) if any of the above information changes during the school year, I will immediately bring the change to the attention of the Superintendent of the St. George Municipal School Unit.

Registration of a student who is not a resident is a fraudulent act. Any student found to have been fraudulently registered will be dropped from the attendance rolls immediately. Parents or guardians making a fraudulent registration may be subject to the payment of retroactive tuition charged for non-resident students.

I further certify that I understand the residency requirements and that I know the penalty for fraudulent registration.

Date: ________________________  Signature: __________________________________________

                                        

Print Name: ________________________________________

        

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TO BE COMPLETED BY TOWN OFFICIAL

Proof of Residency Provided:

If one parent or guardian lives outside of St. George:

The above named parent/guardian, ____________________________________________________, is a resident of the Town of St. George.

Town Official’s Signature: ________________________           Position:  ___________________      

Date:        ___________________