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: _________________