Change of Address for Current Family

1. Children and youths who are sharing the housing of other persons due to loss of housing, economic hardship, or a similar reason; are living in motels, hotels, trailer parks, or camping grounds due to the lack of alternative adequate accommodations; are living in emergency or transitional shelter; are abandoned in hospitals; or are awaiting foster care placement;

2. Children and youths who have a primary nighttime residence that is a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings (within the means of section 103(a)(2)(C));

3. Children and youths who are living in cars, parks, public spaces, abandoned buildings, sub-standard housing, bus or train stations, or similar settings.

Proof of Address

District policy requires a proof of address from parent/guardian within 30 days of a move unless determined homeless by district liaison. A proof of address is one of the following (including a current date, a correct name of at least one parent, and a current address):

• a utility bill or statement,
• a lease agreement,
• home rental contract,
• home purchase agreement, or
• mortgage bill.

Parent/Guardian Signature

By submitting this form, I agree that the information provided is accurate to the best of my knowledge.

Names of parent/guardians moving with child(ren)