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Family Request for an Address Change
The information in this form will be applied district wide, and you will only need ONE FORM SUBMITTED PER FAMILY. Please go to your Parent Portal account under Household Information/Family Members to view your current information. You can also update your home phone number via your Parent Portal Account.
BUSING INFORMATION
Transportation registration is required for
ALL
students AK-12 regardless of bus needs.
Please create an account using the link located
HERE
on the district website. All busing information will be found in the account that you create and no longer in your Portal Account.
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* Indicates required question
Parent/Guardian Name
*
First and last name please
Your answer
List ALL students Currently Attending CCSD
*
List all students separated by a comma
Your answer
Email Address
*
Your answer
Cell/Home Phone Number
*
In case questions arise
Your answer
Will Both Mom and Dad live in New Household
*
Yes, both parents live at the new address
No, parents live in separate houesholds
Other
This Address Change is For
*
All current household members
Only specific people are moving from current household
Primary, create new
Secondary, create new
Primary and secondary are switching
Other
Please list all family members moving to the new address.
*
Please include children, adults and relatives making the move.
Your answer
Did You Move into Another Families Household?
*
Yes
No
If yes, who
Your answer
Previous Street Address
*
Your answer
Previous City
*
Your answer
Previous Zip Code
*
Your answer
New Street Address
*
Your answer
New City
*
Your answer
New Zip
*
Your answer
Previous County
*
Linn
Benton
Johnson
Iowa
Other
New County
*
Linn
Benton
Johnson
Iowa
Other
Effective Date of New Addres
*
MM
/
DD
/
YYYY
Does Your New Residence have a PO Box Number
*
Yes
No
If Yes, Please List the Number, City and Zip
Your answer
Is This New Address in The College Community School District?
*
Yes
No
If Your New Address is Out of the District:
My child/ren will be transferring to their new district
My Child/ren will finish the school year at CCSD and then transfer to their new district
I would like to talk to someone about open enrollment (forms will be mailed to you when address is updated, these MUST be returned to the district office)
Other
Clear selection
Are You an Employee of CCSD?
Employees please update information in Employee Self Serve
Yes
No
Clear selection
Does Any Child in your Household have an IEP (Individualized Education Program)
Yes
No
Clear selection
If yes, please provide the name of the student and building they attend.
Your answer
Additional Comments:
Please tell us anything else you think we might need to know to complete this request an make accurate changes in our Student Information System.
Your answer
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