2025-2026 Change of Address Pacific Coast Academy

Proof of Residence Form
Living in a permanent nighttime residence (ex. house, apartment, condo)Staying in a shelter (family shelter, domestic violence shelter, youth shelter) or Federal Emergency Management Agency (FEMA) trailerSharing housing with other(s) due to loss of housing or income, natural disaster, lack of adequate housing, or similar reasonLive in a car, trailer, park, or campground, abandoned building, or other inadequate accommodations (i.e. lack of water, electricity, or heat)Temporarily living in a motel or hotel due to loss of housing, economic hardship, natural disaster, or similar reasonI am a student 18 years of age or older and live on my own

Proof of Residence Form
Current Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
YesNo
Utility service contract, statement, or payment receipts - e.g. Gas, Water, Electric, Sewage, Trash, Home Phone (cell phone NOT accepted) or Cable (Disconnection utility notices CANNOT be accepted)Rental property contract, lease, or payment receipt (Agreements must be current and must have the signature page reflecting both the renters and owner/landlord signature and date)Correspondence from a government agency - e.g. CalWORKS, Social Security, MediCal, EDD (Unemployment)Permanently residing with another individual and unable to provide an approved proof of residence document in my name.
Affidavit to Verify Residence Form- This form is used if a POR document cannot be provided in your name and you are permanently living with someone else. This form must be downloaded and completed by all parties and uploaded under the Proof of Residence.
Proof of Residence Document Upload (PDF only)

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Military Orders Document Upload (PDF only)

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Military Affidavit Document Upload (PDF only)

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Proof of Residence Document Upload Instructions

How to Convert a Photo to PDF to Share from iPhone or iPad

or scan QR code to access on your mobile device from a computer:

How to Convert Image to PDF in Android (No App)

or scan QR code to access on your mobile device from a computer:

Proof of Residence Form
Current Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
YesNo
Utility service contract, statement, or payment receipts - e.g. Gas, Water, Electric, Sewage, Trash, Home Phone (cell phone NOT accepted) or Cable (Disconnection utility notices CANNOT be accepted)Rental property contract, lease, or payment receipt (Agreements must be current and must have the signature page reflecting both the renters and owner/landlord signature and date)Correspondence from a government agency - e.g. CalWORKS, Social Security, MediCal, EDD (Unemployment)Permanently residing with another individual and unable to provide an approved proof of residence document in my name.
Proof of Residence Document Upload (PDF only)

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Affidavit to Verify Residence Form- This form is used if a POR document cannot be provided in your name and you are permanently living with someone else. This form must be downloaded and completed by all parties and uploaded under the Proof of Residence.
Proof of Residence Document Upload Instructions

How to Convert a Photo to PDF to Share from iPhone or iPad

or scan QR code to access on your mobile device from a computer:

How to Convert Image to PDF in Android (No App)

or scan QR code to access on your mobile device from a computer:

McKinney Vento
Please download and complete this form. You will need to sign it and upload it below or you may submit it to your current HST.
McKinney Vento Upload Form

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Please click the green SUBMIT button now. Thank you for completing the required documentation.
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2025-2026 Change of Address