North Putnam Community Schools Residency Information
This questionnaire is in compliance with the McKinney-Vento Act, U.S.C.A. 42 Section 11302(a).  This information must be provided twice per year to Indiana students.  Your answers will help the Administrator determine residency documents necessary for enrollment of your student(s)  Please select the appropriate answer for each question.  
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Student *
Parent/Guardian  *
School *
Phone Number *
Student Age *
DOB *
MM
/
DD
/
YYYY
Student Grade Level *
Address *
City *
State *
Zip Code *
Is this address temporary or permanent? *
Please choose which of the following situations the student currently resides in (you can choose more than one). *
Required
If you are living in shared housing, please check all of the following reasons that apply:
Are you a student living without your parents or guardians? *
Students who are in temporary, inadequate and homeless living situations have the following rights:

1) Immediate enrollment in the school they last attended or the school in whose attendance area they are currently staying even if they do not have all the documents normally required at the time of enrollment;
2) Access to free meals and textbooks, Title I and other educational programs, and other comparable services including transportation;
3) To attend the same classes and activities that students in other living situations also participate in without fear of being separated or treated differently due to their housing situations.

Any questions about these rights can be directed to the local McKinney-Vento Liaison Coordinator, Mr. Rodney Simpson (765) 522-6218, or the State Coordinator (317) 234-4827.

By signing below, I acknowledge that I have received the above rights.

- Your typed name will serve as your E-Signature
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