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Parent/Guardian Address Change Form
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* Indicates required question
Email
*
Your email
What School Does Your Student Attend?
*
Brimhall
Central Park
Edgerton
ED Williams
Falcon Heights
Harambee
Little Canada
Parkview
Roseville Area Middle School
Roseville Area High School
Fairview Alternative High School
Early Childhood: PreK, ECSE, ECFE
Student Last Name
*
Your answer
Student First Name
*
Your answer
Parent First and Parent Last Name
*
Your answer
Parent Phone Number (xxx) xxx-xxxx
*
Your answer
New Street Address-No P.O. Box as the home address
If you have a PO box as mailing address - add to comments on this form.
*
Please include apartment # (otherwise won't be processed)
Your answer
New City and Zip Code
*
Your answer
Effective Date of Move
*
MM
/
DD
/
YYYY
Does your student need AM transportation? If yes, what address…
Transportation is
not guaranteed.
Type (Home/Daycare): Street Address, Unit # (if applicable), city, zip
*
Your answer
Does your student need PM transportation? If yes, what address…
Transportation is
not guaranteed.
Type (Home/Daycare): Street Address, Unit # (if applicable), city, zip
*
Your answer
Please list all students enrolled in Roseville Area Schools who have a change of address
*
Your answer
Is the student changing schools?
*
Yes. The student(s) will be attending a new neighborhood school.
No. The student(s) will remain enrolled in their current school.
Other. Central Enrollment will contact parent/guardian if needed.
Are the siblings moving as well?
*
Yes
No
Comments: If you have questions regarding Address Changes email: studentdata@isd623.org
Your answer
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