Selection Of School By Joint Custody Parents Form printable pdf download

Selection of School by

Joint Custody Parents

Form

Statement Must Be Notarized Prior To Arrival

NOTE:

to the Growth and Planning Department

We respectfully request that our child(ren) ___________________________________________________________ attend

the Wake County School System based on the fact that we have joint custody (either by separation agreement or court

order) and I, _____________________________________________reside in Wake County at ______________________

_______________________________________________. Attached is a current utility bill that will verify my address.

mother’s address

By this agreement we will use

residence for one-year for enrollment of our child(ren).

father’s address

***************************************************************************************************

MOTHER: _________________________________________________________________________________________

(Last Name)

(First Name)

(M.I.)

ADDRESS: ________________________________________________________________________________________

PHONE: (Home) _________________________________ (Work) ___________________________________________

FATHER: _________________________________________________________________________________________

(Last Name)

(First Name)

(M.I.)

ADDRESS: ________________________________________________________________________________________

PHONE: (Home) _________________________________ (Work) ___________________________________________

Mother’s Signature: __________________________________________________________________________________

(Must be notarized)

Father’s Signature: __________________________________________________________________________________

(Must be notarized)

*************************************************************************************************

State of North Carolina

County of________________________________________

I, ____________________________________, a Notary Public for said County and State, do hereby certify that

_______________________________________and _______________________________________________ personally

appeared before me and acknowledged the due execution of the foregoing instrument.

Witnessed my hand and seal this __________________day of ____________________, __________________________

Signature of Notary ____________________________________________My Commission Expires ________________

, O

; 3 6 0 0 W

, R

, 2 7 6 0 9

R O W T H A N D

L A N N I N G

E P A R T M E N T

F F I C E O F

R O W T H

A N A G E M E N T

A K E

O R E S T

O A D

A L E I G H

N C

Form: JC/v1/August 2007

Selection Of School By Joint Custody Parents Form

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