Online Residency Verification

Phone #

Address

(Street, Apt., City, Zip)

Email Address

(a copy of your affidavit will be emailed to you if you provide an email address)

LIST ALL PRE-K – 8TH GRADE STUDENTS IN YOUR FAMILY IN THE SPACES BELOW

1. Student First Name

1. Student Last Name

1. Student School

1. Student Grade

2. Student First Name

2. Student Last Name

2. Student School

2. Student Grade

3. Student First Name

3. Student Last Name

3. Student School

3. Student Grade

4. Student First Name

4. Student Last Name

4. Student School

4. Student Grade

5. Student First Name

5. Student Last Name

5. Student School

5. Student Grade

6. Student First Name

6. Student Last Name

6. Student School

6. Student Grade

Glenview School District 34
AFFIRMATION OF LEGAL RESIDENCY

I, ,

hereby state that I have lived at the address indicated above since (month/year)

The child(ren) named above are residing at this address and will continue to reside here during the 2022-23 school year.

I consider this address to be my permanent address

I am unable to provide the required documents because...

Address of last permanent residence

Last school attended

If there is no last school attended, please mark N/A.

CHECK ALL THAT APPLY

Living in a shelter, hotel, motel, campground, or other similar situation

Living at a train or bus station, park or in a car

Living in an abandoned apartment/building

Disaster victim

Unaccompanied youth

The child is temporarily housed, awaiting DCFS permanent foster care placement

Other…

I have received the Eligibility and Rights under McKinney-Vento handout

I understand that if, as the custodial parent or legal guardian, I move outside of the legal boundaries of District 34 during the school year, it is my responsibility to notify the principal that I am no longer a legal resident.

In signing this document, I acknowledge having read and understood the following: A person who knowingly or willfully presents to a district representative any false information regarding the residency of a pupil for the purpose of enabling that pupil to attend any school of the district without payment of a non-resident charge shall be guilty of a Class C misdemeanor. (105ILCS 5/1-2012b.)

I understand that if the information above is determined to be false or misleading, resulting in the student named above to not be legally entitled to attendance at Glenview School District 34, the school district may take legal action to recoup valid tuition charges (estimated $14,278 per year per student) plus legal fees which will be my responsibility.

Today's Date

By checking the following box,

I, provide my electronic signature and verify that all information contained above is accurate and correct.

As confirmation of residency, you are required to provide documents as specified in the Residency Requirements.

Homeowners must upload

TWO of the following full documents including name, address and date:

Valid State of Illinois Vehicle Registration
Current copy of electric bill (e.g. ComEd)
Current copy of gas bill (e.g. Nicor)
Most recent village water bill
Most recent cell phone or cable bill

AND

ONE of the following including name, address and date:

Most recent real estate tax bill (www.cookcountytreasurer.com)
Proof of payment of current real estate taxes (e.g. cancelled check or Cook County Treasurer’s receipt); or
Current homeowner’s insurance policy; or
Recent mortgage statement; or
NEW HOMEOWNERS: Settlement Statement from closing documents. (This option is available for families who have recently closed on their homes and have not yet received a current property tax bill.)

Renters

TWO of the following full documents including name, address and date:

Valid State of Illinois Vehicle Registration
Current copy of electric bill (e.g. ComEd)
Most recent village water bill
Most recent cell phone or cable bill

AND

ONE of the following including name, address and date:

Valid lease (signed and dated)
Proof of last two rent payments (cancelled checks, receipts or a signed and dated statement from landlord with phone number)
Current rental insurance policy

Upload a PDF version or picture you have taken of the documents

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