Kan. Admin. Regs. § 91-16-19 - Form of application and affidavit of minor

Current through Register Vol. 40, No. 39, September 30, 2021

The form to be used by minor applicants may be substantially as follows to be filled out in triplicate, one (1) for the unified school district, one (1) for the vocational education institution, and one (1) for the student. The application as required by this regulation and by K.A.R. 91-16-20 shall not be construed to limit any additional information needed by the vocational education institution in their enrollment procedures.

No. 25-8 Execute in Triplicate

STATE OF KANSAS

KANSAS STATE BOARD OF EDUCATION

DEPARTMENT OF EDUCATION

Kansas State Education Building

120 East Tenth Street, Topeka, Kansas 66612

Application of Minor Student for Admission to

Vocational Education Institution and for

Payment of Tuition

Name _____

(Last) (First) (Middle)

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) Name and address of parent or guardian _____

(Name) _____

(Street or Route)

(City) (State) (Zip)

Application for approval to attend _____

(Name of course or program) at the _____

(Vocational education institution) beginning and for payment of

(Date)

tuition by Unified School District No. _____

__________, Kansas.

(County) __________

(Student's signature) (Date) __________

(Parent or guardian'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 the parent or legal guardian of __________, a minor, and 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)

Further affiant says not.

(Signature) Subscribed and sworn to before me this _____ day of __________.

(Notary Public) My commission expires __________.

Notes

Kan. Admin. Regs. § 91-16-19
Authorized by K.S.A. 72-4418; effective, E-71-17, April 5, 1971; effective Jan. 1, 1972; amended May 1, 1979.

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