Kan. Admin. Regs. § 91-16-20 - Form of application and affidavit of person of age of majority

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

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 vocational education institution, and one (1) for the student.

No. 25-9 Execute in Triplicate




Kansas State Education Building

120 East Tenth Street, Topeka, Kansas 66612

Application of Student of Legal Age 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)

Application for approval to attend _____

(Name of course or program) at the _____

(Vocational education institution) beginning __________.


(Student's signature) (Date)

Affidavit of Residency of Applicant State of Kansas


__________ 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 plan to move to __________ (City) (State) on _____ for the sole purpose of attending vocational __________ (Date) education courses and programs at the _____.

(Name of institution)

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 _____.


Kan. Admin. Regs. § 91-16-20
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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