Millennium Community School Change of Address
Previous Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
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Next
First Student's Information
Name
*
First Name
Middle Name
Last Name
Suffix
Birth Date
*
-
Month
-
Day
Year
Date
Grade
*
Please Select
KG
1st
2nd
3rd
4th
5th
6th
7th
8th
School Name
*
Second Student's Information
*if necessary
Name
First Name
Middle Name
Last Name
Suffix (if any)
Birth Date
-
Month
-
Day
Year
Date
Grade
Please Select
KG
1st
2nd
3rd
4th
5th
6th
7th
8th
School Name
Third Student's Information
*if necessary
Name
First Name
Middle Name
Last Name
Suffix (if any)
Birth Date
-
Month
-
Day
Year
Date
Grade
Please Select
KG
1st
2nd
3rd
4th
5th
6th
7th
8th
School Name
Fourth Student's Information
*if necessary
Name
First Name
Middle Name
Last Name
Suffix (if any)
Birth Date
-
Month
-
Day
Year
Date
Grade
Please Select
KG
1st
2nd
3rd
4th
5th
6th
7th
8th
School Name
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Primary/Residential Household (This is the the address where the student(s) listed)
Home Address
*
Street Address
Mailing Address (if different from Home Address)
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Mailing Address (if different from Home Address)
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Home Number
Please enter a valid phone number.
Cell Number
*
Please enter a valid phone number.
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Next
Primary/Residential Parent or Guardian
(This is the primary/residential parent/guardian for student(s) listed.)
Name
*
First Name
Middle Name
Last Name
Gender
*
Male
Female
Employer
Work Number
Please enter a valid phone number.
Cell Number
*
Please enter a valid phone number.
Email
*
example@example.com
Has Custody
*
Yes
No
Relationship to student(s)
*
Parent
Legal Guardian (by court)
Stepparent
Foster Parent
Other
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Parent, Guardian, or Authorized Adult (This is the second parent/guardian or authorized adult)
Name
First Name
Middle Name
Last Name
Relationship to Student(s)
Parent
Legal Guardian (by court)
Stepparent
Foster Parent
Other
Gender
Male
Female
Has Custody
Yes
No
Employer
Work Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Email
example@example.com
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Next
Emergency Contact(s) Information
Emergency Contact 1
Full Name
Relationship
Home Phone
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Emergency Contact 2
Relatioship
Home Phone
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Emergency Contact 3
Relationship
Home Phone
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
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Next
Proof of Residency
Proof of Residency
*
Browse Files
Drag and drop files here
Choose a file
*Lease, Utility Bill, Morgage or Residency Affidavit
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of
Parent/Legal Guardian Name (Printed)
*
First Name
Last Name
Signature
*
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