Fillable Printable Proof Of Residency Template Letter
Fillable Printable Proof Of Residency Template Letter
Proof Of Residency Template Letter
Proof of Residence
Per Rutherford County Board of Education directive, it is required coaches verify that an
athlete’s address is within the school attendance zone prior to beginning practice each year.
You must submit this form along with the following documents to be eligible to tryout or
practice:
1. A current utility bill. MUST BE A GAS, ELECTRIC, OR WATER BILL. (A cell
phone or cable bill will not be accepted as proof of residence.)
2. A copy of zone verification from the Rutherford County Schools Website. Type in
your complete street address and grade. Print the screen that verifies that you are zoned
for Blackman High School.
Student Name__________________________________________________________
*Address_______________________________________________________________
* This address must be the primary residence of the student’s custodial parent/guardian.
Parent/Guardian Name___________________________________________________
Phone Number_________________________________________________________
I hereby state the above information is correct.
_________________________________ _______________________
Signature of Student Date
_________________________________ ________________________
Signature of Parent/Guardian Date