7:060-E2 Letter of Residence to Be Used When the Person Seeking to Enroll a Student Is Living with a District Resident

 

A person seeking to enroll a child should use this form as evidence of residency when he or she cannot produce a lease, purchase property agreement, or other similar document – other documents will also be required to establish residency. The School District reserves the right to evaluate the evidence presented; completing this form does not guarantee admission.

To be completed by the individual enrolling the child and returned to the Principal. Please print.

Child:  ______________________________________  School:  _______________

Individual Enrolling the child:  ___________________________________________

Telephone Number:  __________________________

Relationship to the child:  _________________________________________

Resident Address/City/Zip:  _______________________________________________

Signature of individual enrolling the student:  _________________________________

Date:  _________________________

To be completed and signed by the individual who is responsible for the residence. Please print.

Name of the individual who is responsible for the residence:  ______________________

Telephone:  ________________________

I am responsible for this residence by:

_____ownership,  _____lease, or  _____other _____________________

Total number of:

Persons living at this residence ____  Rooms in residence ___  Bedrooms ___

State the reasons for this living arrangement, including your relationship to the individual enrolling the child:

_____________________________________________________________________________

I certify that this information is true and that the individuals named above are living in my residence.

___________________________________________          Date:  _____________

Signature of the individual who is responsible for this residence:

WARNING: If a student is determined to be a nonresident of the District for whom tuition must be charged, the persons enrolling the student are liable for non-resident tuition from the date the student began attending a District school as a non-resident.

A person who knowingly enrolls or attempts to enroll in this School District on a tuition-free basis a student known by that person to be a nonresident of the district is guilty of a Class C misdemeanor, except in very limited situations as defined in State law (105 ILCS 5/10-20.12b(e).

A person who knowingly or willfully presents to the School District any false information regarding the residency of a student for the purpose of enabling that student to attend any school in that district without the payment of a nonresident tuition charge is guilty of a Class C misdemeanor (105 ILCS 5/10-20.12b(f).

Date Approved:   06/24/2009