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Vestal CSD Address Update Form

The Vestal Central School District does not require families to submit an address update for each student. You MAY submit one address update form with all of your student(s) listed in the field titled "Please list all students in the household: (if no other students please enter N/A)".

Address change requirements:

Complete the address change form in order to change your address. Before submitting, you will be asked to attach 2 NEW proofs of residency- dated within the last 2 months.

(examples of acceptable proofs are listed where you will need to upload them)

Student's First Name *

Student's Middle Name

Student's Last Name *

Student's Date of Birth (ex. 6 Jun 2023) *

Student's Gender *

Male

Female

Other

Is the student Hispanic? *

Yes

Student's Race: *

White
American Indian
Alaskan Native
Asian
Black or African American
Native Hawaiian / Other Pacific Islander

Student's Primary Language *

Student's Secondary Language (if applicable)

Primary Contact's First Name *

Primary Contact's Last Name *

Primary Contact Relationship to Student: *

Primary Contact's Email *

Primary Contact's Cell Phone Number *

Primary Contact's Work Phone Number

Primary Contact's Home Phone Number *

Please enter the new address information below.

Primary Contact's House Number *

Primary Contact's Street Name *

Primary Contact's Unit Number

Primary Contact's City *

Primary Contact's State *

Primary Contact's ZIP Code *

If mailing address is different please enter below.

Mailing Address P.O. Box, Unit #:

Mailing Address Street Name:

Mailing Address City:

Mailing Address State:

Mailing Address Zip Code:

Emergency Contact First Name *

Emergency Contact Last Name *

Emergency Contact 10 Digit Home Phone Number *

Emergency Contact Relationship *

Emergency Contact Allowed to Pick Up Student? *

Yes

Emergency Contact Living with Student? *

Yes

Parent/Guardian #2 Name:

Parent/Guardian #2 Cell Phone:

Parent/Guardian #2 Work Phone:

Parent/Guardian #2 Home Phone:

Parent/Guardian #2 Relationship:

Parent/Guardian #2 Living with Student:

Yes

Parent/Guardian #2 Receive School Mailings/Communications?

Yes

Parent/Guardian #2 Allowed to Pick Up?

Yes

Additional Contact Name:

Additional Contact Cell Phone #:

Additional Contact Relationship to the Student:

Additional Contact Allowed to Pick Up?

Yes

Additional Contact Living with the Student?

Yes

If you have any more contacts you would like to add to the student's pick up and/or mailing list, please reach out to our registrar at registration@vestal.k12.ny.us or call at: 607-757-3500.

Has the student ever attended a Vestal Central School District before? *

Yes

Has the student ever received any special education services, have an IEP, or 504? *

Yes

Will you be requesting transportation for your student? (District transportation is not provided for UPK students or students within walking zones) *

Yes

Does your family work in agricultural or related industries and moved across districts or state lines several times within as 12-36 month period of time, following the various crops by season? *

Yes

Acceptable Proof of Residency

Need (2) forms of acceptable proofs of residency dated within the past 2 months.

A copy of residential lease or proof of ownership of a home, such as a deed or a mortgage statement.

Official driver’s license, learners permit or non-driver Identification.

Utility or other bill (NYSEG, Spectrum, or a garbage service).

Voter registration

Car/ renters/ homeowners insurance.

Pay stub

Tax form

Bank statement

Documents issued by federal, state, or local agencies (such as from a local social services agency).

Evidence of custody of the child, including but not limited to judicial custody orders or guardianship papers.

*We cannot accept a copy of an envelope that has been mailed to you. We will need a full copy of the document inside. *

Please attach First proof of residency here: *

List of Allowed file types

Please attach Second proof of residency here *

List of Allowed file types

Do you have a custody agreement, or any court documentation regarding any custody issues or foster care? *

Yes

If there is, please upload the most current documentation here.

List of Allowed file types

Please list all students in the household: (if no other students please enter N/A) *

Housing Questionnaire

New Address Zoned Elementary Building (please visit https://docs.google.com/spreadsheets/d/1JWZWVpBzypv-q6df1tsib7PIpVZX7zmZn-6BB871Ay8/edit#gid=0 to find your address zoning) *

African Road Elementary
Clayton Ave Elementary
Glenwood Ave Elementary
Tioga Hills Elementary
Vestal Hills Elementary
Vestal Middle School
Vestal High School

ID# (optional)

Address (include City, State and Zip Code) *

10 Digit Phone Number *

The answer you give below will help the district determine what services you or your child may receive under the McKinney-Vento Act. Students who are protected under the McKinney-Vento Act are entitled to immediate enrollment in school even if the do not have the documentation 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? (choose one) *

In permanent housing

In a shelter

With another family or other person because of loss of housing or as a result of economic hardship (doubled up)

In a hotel/motel

In a car, park, bus, train or campsite

Other temporary living situation

If you chose 'other temporary living situation' please explain your living situation:

Parent/Guardian name, or student (for unaccompanied homeless youth) *

Acceptance *
Yes, I confirm all the above information is correct.

Decline

Your Name

Please sign below Show me how

Clear

Today's Date: *

If any box other than 'in permanent housing' is checked, then the student/family should be immediately referred to the MV Liaison. In such cases, proof of residency and other documents normally needed for enrollment are NOT required and the student is to be immediately enrolled. After the student has been enrolled, the district/school must contact the previous district/school attended to request the student's educational records, including immunization records, and the enrolling districts LEA Liaison must help the student get any other necessary documents of immunization.

Note to schools/LEAS: if the student is NOT living in permanent housing, please ensure that the Designation Form is completed