2023/24 Onteora Private/Parochial Transportation Request Form

Onteora Central School District
PO Box 300
4166 Route 28
Boiceville, NY 12412
(845) 657-6383
(845) 657-8742 FAX

Private School Transportation

In order for the Onteora Central School District to provide transportation to students enrolled in private schools, proof of residency in the district must be established.

Please complete this packet and provide the appropriate documents as specified on the Residency Requirements page.

Proof of age must also be provided. Please see below for guidelines.

Proof of Age

A certified transcript of a birth certificate or record of baptism (including a certified transcript of a foreign birth certificate or record of baptism) or, if neither is available, a passport (including foreign passport), will suffice to determine a child’s age.

The following are examples of other documentary evidence (which must have been in existence for at least two years) that may be considered to establish a student’s age if a certified transcript of a birth certificate or record of baptism (domestic or foreign), or passport (domestic or foreign), is unavailable. This list is not intended to be exhaustive, nor is it a list of required documentation:

• Consulate identification card
• Court order or other court-issued documents
• Documents issued by the federal, state or local agencies
(e.g. local social service agency, federal Office of Refugee Resettlement)
• Hospital or health records
• Military dependent identification card
• Native American tribal document
• Official driver’s license
• Records from non-profit international aid agencies and voluntary agencies
• School photo ID with date of birth
• State of or other government issued documentation

Any questions, please contact the District Registrar at (845)657-6383 x 1023

TRANSPORTATION DEPARTMENT

ONTEORA CENTRAL SCHOOL DISTRICT

PO BOX 300

4166 ROUTE 28

BOICEVILLE, NY 12412

PRIVATE & PAROCHIAL SCHOOL TRANSPORTATION APPLICATION
In accordance with the Laws of the State of New York, I hereby formally request transportation for my child who will attend the schoolschool in the   school yearschool year.
Student Name:   Last Name   First Name   DOB:   Date
Entering Grade:grade
Student Home Address:   Street Address      City      Zip
Home Phone:   Area Code   Phone Number
Other Emergency Phone:   Area Code   Phone Number
School attended by your child in the previous school year   School
Please remember that the Onteora Central School District does not transport to Private & Parochial Schools on days when our District is closed for students.

A request must be completed for each student and submitted on or before April 1 as determined by Education Law Section 3635. To be eligible for service, all students must be registered with the Onteora Central School District and must meet the same requirements as students attending the Onteora Central School District.
Date

MonthDayYear
Date
Parent / Guardian Signature

Clear
Date

MonthDayYear
Date
School Official Signature*

Clear
-------------------------------- Below for District use only -----------------------------

Onteora Central School District

PO Box 300

4166 Route 28

Boiceville, NY 12412

Tel. (845)657-6383 Fax (845)657-8742

Dear Parents/Guardians,

Welcome! In order to be cnrolled in the Onteora Central School District, you must reside within the boundaries of the District. Proof of residency is required to complete enrollment and must be presented within three days of initial registration. At least two documents should be submitted.

All documents must be current and must contain parent's/guardian's name. The physical address of the residence must appear on the documents. The District will not accept a P.O. Box as a physical address.

The following is a non-exhaustive list of documents that will be accepted to establish residency:

·      Recent School Tax Bill
·      Settlement Statement from Closing
·      Bank Statement
·      Cancelled Check
·      Change of Address Verification from the United States Postal Service
·      Pay Stub
·      Credit Card Statement on Company Letterhead
·      Homeowners/Renters Insurance Policy of Proof of Claim
·      Federal or NYS Income Tax, W-2 or Earnings Statement
·      Jury Duty Notice
·      Military Orders that are still in effect
·      Moving Company Receipt
·      NYS Certificate of Title
·      NYS Professional License
·      Deed or Proof of Current Mortgage
·      Residential Lease
·      Retirement Statement
·      Selective Service Card
·      Social Security Statement
·      SSI Award Statement

Unemployment Benefit Statement

·      Utility Bill
·      Voter Registration Notification Card
·      Welfare Benefit Statement
·      Notarized or signed statement from a third-party landlord, owner or tenant with whom you are sharing property
·      Notarized Affidavit of Property Owner/Landlord in Support of Residency (form attached)
·      Notarized or signed statement from a third party establishing your physical presence in the District.
·      Official driver’s license, learner’s permit, or non-driver identification
·      Government issued identification.
·      Documents issued by federal, state or local agencies (e.g. Office of Refugee Resettlement)
·      Membership documents based on residency (e.g. library card)·

The District will evaluate all submitted documentation to determine residency.

Please note: Proof of Residency is required for all students enrolling whether or not older siblings are currently attending the Onteora Central School District. For Kindergarten students, they may participate in the screening but your child will not be considered enrolled until proof of residency is provided for their file.

AFFIDAVIT OF PROPERTY OWNER

IN SUPPORT OF RESIDENCY IN THE

ONTEORA CENTRAL SCHOOL DISTRICT

STATE OF NEW YORK )

) SS.:

COUNTY OF ULSTER. )
I, Name , a property owner of the dwelling located at Street Address/Apt # City State Zip hereby certify that I am renting space in this dwelling on a weekly/monthly/yearly basis beginning on Date
The following persons are identified as tenants having the right to be occupants in the dwelling:
Parent/Guardian
Parent/Guardian
Name(s) of Child(ren)

First NameMiddle NameLast Name
2

First NameMiddle NameLast Name
3

First NameMiddle NameLast Name
4

First NameMiddle NameLast Name
5

First NameMiddle NameLast Name
List all persons residing in this dwelling

First NameMiddle NameLast Name
2

First NameMiddle NameLast Name
3

First NameMiddle NameLast Name
4

First NameMiddle NameLast Name
5

First NameMiddle NameLast Name
The payment of the Electric Bill is included in rent:

YesNo
I certify that the information provided on this form is true and correct and that the statements made herein are being made under the penalties of perjury, knowing that the Onteora Central School District will rely upon them in determining whether the above-named child(ren) reside in the school district.
(Signature of Property Owner)

Clear
(Print Name)
Making a false statement regarding living arrangements is a violation of the law, to wit: a violation of section 210.35 and 210.45 of the NY Penal Law, which are Class A misdemeanors and may be punishable by up to a fine of up to $1,000 and/or up to one year of imprisonment.
Sworn to before me this blanks Day Type a label 20 blank (Notary Public).

Notary

Stamp

Should be Empty:

Private School Transportation

Student Information

Parent/Guardian A (Student's Primary Residence)

Step Parent at this Address

Parent/Guardian B

Step Parent at this Address

Student's Educational Background

Special Education Services Information

Siblings/Other Children Living at Primary Address

Other Adults Living at Primary Address

Student's Previous Address if New to the Onteora School District

Onteora Central School District

AFFIDAVIT OF PROPERTY OWNER

IN SUPPORT OF RESIDENCY IN THE

ONTEORA CENTRAL SCHOOL DISTRICT