School Governance and Facilities
RESIDENCY ENROLLMENT CHECKLIST
Printer Friendly Version (pdf)
Name of Parent/Guardian__________________________________________ Address________________________________________________________ City/State__________________________________ Zip________________ Telephone Number - Home__________________ Work_________________
Name of Student__________________________________________________ Address_________________________________________________________ City/State___________________________________________ Zip________ Telephone Number_______________________ Date of Birth_____________ Address Verification (Parent/Legal Guardian) (Attach copy of document) ____Rental contract ____Real Estate Contract signed by all parties ____Utilities Bill/Deposit Receipt ____Other, such as payroll check, driver's license, W-4, employment documents Basis for Admission of Student (167.020 RSMo) ____Resides with parent in the school district ____Resides with legal guardian in the school district (Copy of court ordered guardianship must be attached. A guardian may be appointed for the sole and specific purpose of school registration (SB944)). ____Resides with a military guardian in the school district (SB944). ____Homeless child (person less than 21 years of age who lacks a fixed, regular and adequate nighttime residence), including a child who is:
Give address or directions______________________________________ ____Special circumstances (Section 167.151, RSMo):
____Parent is a teacher under contract with the district (Board policy required-Section 167.151, RSMo, 168.151, RSMo) ____Parent is a regular employee with the district (Board policy required-Section 163.011, RSMo) Other exemptions to the residency requirements (Section 167.020.6, RSMo) ____Attending school not in the pupil’s district of residence as a participant in an interdistrict transfer program established under a court-ordered desegregation program ____A ward of the state and has been placed in a residential care facility by state officials* ____Has been placed in a residential care facility due to a mental illness or developmental disability* ____Has been placed in a residential facility by a juvenile court* ____Has a disability identified under state eligibility criteria if the student is in the district for reason other than accessing the district’s educational program *The district of residence will be billed for the local tax effort for the student(s) attending under these circumstances. Date of Student Admission ______________________________________ ____Student denied admission. Date of denial_______________________ ____Waiver requested. Date of request____________________________ WAIVER INFORMATION Waiver requested by: a.____Parent b.____Legal guardian c.____Student (at least 18 years old) d.____Other _________________________________________________
Name of person/relative student resides with ____________________________________ Relationship_____________________________________________ Address________________________________________________ City/State/Zip___________________________________________ Address Verification______________________________________ Reason why student is living with person/relative _________________________________ ___________________________________________________________ ____ Other reasons showing hardship or good cause_________________ ___________________________________________________________ Hearing Date (must be within 45 days of request)_______________________________________ ____Student admitted pending decision on waiver request Date student admitted_________________________________________ ____Waiver granted. Date______________________________________ ____Waiver denied. Date_______________________________________ Students attending school pursuant to the above information may be counted for state aid purposes. Nonresident students who may enroll and are not counted by the district for state aid. ____Tuition ____Tax credit tuition-Any person who pays a school tax in any other district than that in which he resides may send his children to any public school in the district in which the tax is paid and receive as a credit on the amount charged for tuition the amount of the school tax paid to the district (Section 167.151(3), RSMo) ____Transportation Hardship as assigned by the commissioner of education (Section 167.121, RSMo) ____Attending a regional or cooperative alternative education program or an alternative education program on a contractual basis (Section 167.020.6, RSMo) |