Application For Determination Of Residency Conroe Independent School District
ADVERTISEMENT
1
2Application for Determination of Residency
Conroe Independent School District
This application must be submitted by a parent, guardian, or other person having lawful control
of each student under 18 years of age who claims a residence in the Conroe Independent School District
separate and apart from the residence of the student’s parent, guardian, or other person having
lawful control of the student.
Student Information
Full legal name of student
______________________________________________________________________________________________________________________________________________________________________
Sex
Age
Date of birth
___________________
___________________
______________________________________________________________________________________________________________________________________
Current grade level
Last school district and school attended
___________________
_____________________________________________________________________________________________
Social Security number
___________________________________________________________________________________________________________________________________________________________________________
Does the student participate in extra-curricular activities?
yes
no
If yes, what activities
______________________________________________________________________________________________________________________________________________________________________________
Has the student been removed to a DAEP or expelled within the preceding school year?
yes
no
If yes, please explain
______________________________________________________________________________________________________________________________________________________________________________
Has the student engaged in delinquent conduct or
conduct indicating a need for supervision and is on probation or other condition of release for that conduct?
yes
no
If yes, please explain
______________________________________________________________________________________________________________________________________________________________________________
Has the student been convicted of a criminal offense and is on probation or other condition of release?
yes
no
If yes, please explain
______________________________________________________________________________________________________________________________________________________________________________
Parent/Guardian Information
Full legal name of parent/guardian
_______________________________________________________________________________________________________________________________________________________
Address
__________________________________________________________________________________________________________________________________________________________________________________________________
City
State
Zip
_________________________________________________________________________________________________________________
______________________________
________________________________________
Father’s telephone work
home
_____________________________________________________________________________
_______________________________________________________________________________
Mother’s telephone work
home
_____________________________________________________________________________
_______________________________________________________________________________
Residence within District
Name of CISD resident with whom student is residing
_________________________________________________________________________________________________________________________
Address
__________________________________________________________________________________________________________________________________________________________________________________________________
City
State
Zip
_________________________________________________________________________________________________________________
______________________________
________________________________________
Telephone number work
home
_____________________________________________________________________________
_______________________________________________________________________________
Date residency began
Relationship with student
__________________________________________________________
_____________________________________________________________________
Is this the address where the student spends weeknights
yes
no
If no, where does the student sleep during the week?
___________________________________________________________________________________________________________________________
Reason for residing apart from parent/guardian
___________________________________________________________________________________________________________________________________
Warning: It is a criminal offense pursuant to Texas Penal Code 37.10 for a person to knowingly falsify information on
a form required for a student’s enrollment in the District. This is such a form. A person who falsifies such
information will be liable for tuition fees for the period during which the ineligible student is enrolled.
CISD-58 (7/03)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal