Fillable Printable Community High School District 128Vernon Hills High SchoolWalk-In Proof of Residency2016
Fillable Printable Community High School District 128Vernon Hills High SchoolWalk-In Proof of Residency2016
Community High School District 128Vernon Hills High SchoolWalk-In Proof of Residency2016
Community High School District 128
Vernon Hills High School
Walk-In Proof of Residency
2016
Welcome new Cougar parents! We are excited for you and your child to be a part of our school. We
are committed to making the next four years of your student’s educational experience a rewarding
one.
District 128 is dedicated to the academic success of all students within our attendance boundaries.
As good stewards of our financial resources, we require all new students to provide initial proof of
residency within Vernon Hills High School attendance boundaries.
Proof of residency is required by submitting original documentation in person. The
person with whom the student lives in the District and who claims custody of the student
must provide this form (reverse side) in person along with a total of three (3) supporting
original documents*:
One (1) document from Category I (described below)
Two (2) documents from Category II (described below)
All documents must show the same address and be deemed acceptable to the District.
*If proof of residency cannot be made using the documentation listed above, please contact Andrew
Young at 847-932-2214.
Category I – One (1) document showing proper name and address
Most Recent Real Estate Tax Bill
Mortgage Statement
Blue assessment card from Lake County Assessor’s Office
Closing Statement for purchase of residence
Signed current lease (all pages) plus proof of last two (2) rent payments (cancelled
checks or landlord’s receipts). Lease must list all school age children living in premises
or a notarized letter from the landlord must accompany the lease. Landlord’s name,
address and phone number must be on the lease.
AND
Category II – Two (2) documents showing proper name and address
Utility Bill (Gas, Electric, Water) within the last 60 days
Telephone bill or Cable TV bill within the last 60 days (land line only / no cell phones)
Car insurance or car registration
Homeowner’s or renter’s insurance
Voter Registration Card
Community High School District 128
Vernon Hills High School
Proof of Residency Statement
Student Name: ________________________________________ Home Phone: ___________________
Address: __________________________________________________________________________________
This proof of residency form is to attest that the above child is not enrolling in the district solely for
school purposes and is living on a permanent basis with the person having complete custody and
control. Registration of a student who is not a resident is a fraudulent act. Any student found to
have been fraudulently registered will be dropped from the attendance rolls immediately.
“A person who knowingly or willfully presents to any school district any false information
regarding the residency of a pupil for the purpose of enabling that pupil to attend any
school in that district shall be guilty of a Class C misdemeanor.” (105 ILCS 5/10-20.12b)
_____________________________________________________________________________________________
OFFICE USE ONLY – DO NOT WRITE BELOW THIS POINT
____________________________________________________________________________________________
Category I – (one (1) document showing proper name and address)
Most Recent Real Estate Tax Bill
Mortgage Statement
Closing Statement for purchase of residence
Signed current lease (all pages) plus proof of last two (2) rent payments
Category II – (two (2) documents showing proper name and address)
ONLY ONE Utility Bill (Gas, Electric, Water) within the last 60 days
Telephone bill or Cable TV Bill within the last 60 days (land line only / no cell phones)
Car insurance or car registration
I certify that as parent/guardian of the student listed above I am a resident of
Vernon Hills High School attendance area and that I understand the residency
requirements and know the penalty for fraudulent registration.
_________________________________________________________________________________
Parent/Guardian Name(S) – Please Print
_______________________________________________________ _________________
Signature of Parent/Guardian Date
Relationship to Student _______________________________________________________
Homeowner’s or renter’s insurance
Voter Registration Card
Public Aid Card or Kids Care medical card
Received by: __________________________________________________ Date: _________________
