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Enrollment Form-Residency Questionnaire

Required

Building Bridges for today’s students to cross into tomorrow’s world with equity, innovation and optimism
Registration Office∙ 13A Dickinson Avenue∙ Nyack, NY 10960
Phone: (845)353-7038 ∙ Fax (845) 353-7019 ∙Email: smena@nyackschools.org
 
ENROLLMENT FORM-RESIDENCY QUESTIONNAIRE
Name of Student:required
First Name
Middle (optional)
Last Name
Gender:required
Must contain a date in MM/DD/YYYY format
(preschool-12)
(Optional)
The answer you give below will help the district determine what services you or your child may be able to receive under the Mc-Kinney-Vento Act. Students who are protected under the Mc-Kinney-Vento Act are entitled to immediate enrollment in school even if they don’t have the documents normally needed, such as proof of residency, school records, immunization records, or birth certificate. Students who are protected under the McKinney-Vento Act may also be entitled to free transportation and other services.
Where is the student currently living? (Please check one box.)required
If you selected any of the above options, other than permanent housing, please STOP and contact the Registrar at 845-353-7038
Print name of Parent or Guardian:required
First Name
Last Name
Attach up to 1 file with a maximum size of 10MB
No file chosen
Must contain a date in MM/DD/YYYY format

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