Kan. Admin. Regs. § 91-16-20 - Form of application and affidavit of person of age of majority
The form to be used by applicant of legal age may be
substantially as follows to be filled out in triplicate, one (1) for the
unified school district, one (1) for the
No. 25-9 Execute in Triplicate
STATE OF KANSAS
KANSAS
DEPARTMENT OF EDUCATION
Kansas State Education Building
120 East Tenth Street, Topeka, Kansas 66612
Application of Student of Legal Age for Admission to
Name _____
Post Office Address
(Street or Route)
(City) (State) (Zip)
Date of birth _____
(Month) (Day) (Year)
Social Security Number _____
Marital status (M or S)
Unified School District No. _____,
(Of applicant's residence)
(City) (County) (State)
Application for approval to attend _____
(Name of course or
(
(Date)
(Student's signature) (Date)
Affidavit of Residency of Applicant State of Kansas
ss:
__________ County
}
I, _____, of lawful age, being first duly sworn, on oath say:
That I am a legal resident of Unified School District No. __________ County, Kansas, with my post office address being __________
(Street or Route) _____,
(City) (State) (Zip)
and that I have been a resident of said Unified School District __________.
(Period of time)
(This part of affidavit, if applicable, is to be used in addition for out-district students)
That I moved or
(Name of
My present post office address is _____
(Street or Route)
(City) (State) (Zip)
(This part of affidavit, if applicable, is to be used in addition if resident of less than six months)
That I moved to __________
(City) (State)
on __________ with the express intent and purpose of __________ (Date)
making it my permanent or indefinite place of residence.
Further affiant says not.
__________ (Signature) Subscribed and sworn to before me this _____ day of _____, 19_____.
(Notary Public) My commission expires _____.
Notes
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