Proof Of Residency Form

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Willis Independent School District
District PEIMS Office
202 W. Rogers Road
Willis, Texas 77378
936-890-7534
Proof of Residency Form
Date: ________________________
Campus: ____________________________
Student Name (Full):______________________________________ Grade: ________
I hereby certify that I am a resident of the Willis Independent School District and that my legal residence is the
following address:
_______________________________________ _____________________ _______________
Street Address
City
Zip
I am aware that in order for my child to attend school in the Willis Independent School District, I must
maintain full-time residence in the district. I acknowledge that I have read and understand the penalties of
falsified information as stated in the Texas School Law Bulletin Section 25.001 (h) printed below. I also agree
to inform the proper school authorities immediately should I move from this address above.
§ 25.001. ADMISSION (from the Texas School Law Bulletin)
(h) In addition to the penalty provided by Section 37.10, Penal Code, a person who knowingly falsifies information on a
form required for enrollment of a student in a school district is liable to the district if the student is not eligible for
enrollment in the district but is enrolled on the basis of the false information. The person is liable, for the period during
which the ineligible student is enrolled, for the greater of:
(1) the maximum tuition fee the district may charge under Section 25.038; or
(2) the amount the district has budgeted for each student as maintenance and operating expenses
Signature of Parent/Guardian: _____________________________________________________
Home Phone: ________________________ Work/Cell Phone:__________________________
Acceptable documents that show proof of residency include:
* Utility bill
* Lease/Rental agreement
* Sales agreement

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