Greenfield-Central Community School Corporation - Residency Information Form
This questionnaire is in compliance with the McKinney-Vento Act, U.S.C.A. 42 Section 11302(a). Your answers will help the administrator determine residency documents necessary for enrollment of your student(s). Greenfield-Central sends this questionnaire to all parent(s)/guardian(s)/unattached youth twice a year in accordance with legal requirements. Please complete at your earliest convenience.
Student Name *
Your answer
Parent/Guardian Name *
Your answer
School Student Attends *
Your answer
Phone Number *
Your answer
Age *
Your answer
Grade *
Your answer
Date of Birth *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Please choose which of the following situations the student currently resides in (may choose more than one): *
Required
If you are living in shared housing, please check all of the following reasons that apply:
Are you a student living without your parents or guardians?
Residency and Educational Rights
Students who are in temporary, inadequate, and homeless living situations have the following rights:

1) Immediate enrollment in the school they last attended or the school in whose attendance area they are currently staying even if they do not have all of the documents normally required at the time of enrollment;

2) Access to free meals and textbooks, Title I and other education programs, and other comparable services including transportation;

3) To attend the same classes and activities that students in other living situations also participate in without fear of being separated or treated differently due to their housing situations.

Any questions about these rights can be directed to the McKinney-Vento Liaison, Terry Miller, at 317-462-1492 or the State Coordinator at (317) 234-4827.

By signing below, I acknowledge that I have received and understand the above rights.

Electronic Signature of Parent/Guardian/Unattached Youth *
Your answer
Date *
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