Student Change of Address Form

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Student Change of Address Form

(Residency Questionnaire)This form is to be used if a student's primary residence changes during the school year (including address changes within the district). This questionnaire is intended to address the McKinney-Vento Act, 42 U.S.C. 11435. The Answers to this residency information help determine the services the student may be eligible to receive.

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* Indicates required question

Student's Name *

Your answer

Date of Birth *

Your answer

Name of person completing this form.

Your answer

Phone number

Provide a phone number where we can reach you if necessary.

Your answer

Are you the Legal Guardian?

Yes

No

Clear selection

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