Kan. Admin. Regs. § 91-16-19
The form to be used by minor applicants may be substantially as follows to be filled out in triplicate, one (1) for the unified school district, one (1) for the vocational education institution, and one (1) for the student. The application as required by this regulation and by K.A.R. 91-16-20 shall not be construed to limit any additional information needed by the vocational education institution in their enrollment procedures.
| No. 25-8 | Execute in Triplicate |
| STATE OF KANSAS KANSAS STATE BOARD OF EDUCATION DEPARTMENT OF EDUCATION Kansas State Education Building 120 East Tenth Street, Topeka, Kansas 66612 | |
| Application of Minor Student for Admission to Vocational Education Institution and for Payment of Tuition | |
| Name | |
| __________________________________ | |
| (Last) | |
| __________________________________ | |
| (First) | |
| __________________________________ | |
| (Middle) | |
| Post Office Address | |
| __________________________________ | |
| (Street or Route) | |
| __________________________________ | |
| (City) | |
| __________________________________ | |
| (State) | |
| __________________________________ | |
| (Zip) | |
| Date of Birth | |
| __________________________________ | |
| (Month) | |
| __________________________________ | |
| (Day) | |
| __________________________________ | |
| (Year) | |
| Social Security Number | |
| _________ _________ _________ | |
| Marital status | |
| _________________ | |
| (M or S) | |
| Unified School District No. | |
| __________________________________, | |
| (Of applicant's residence) | |
| __________________________________ | |
| (City) | |
| __________________________________ | |
| (County) | |
| __________________________________ | |
| (State) | |
| Name and address of parent or guardian | |
| __________________________________ | |
| (Name) | |
| __________________________________ | |
| (Street or Route) | |
| __________________________________ | |
| (City) | |
| __________________________________ | |
| (State) | |
| __________________________________ | |
| (Zip) | |
| Application for approval to attend | |
| __________________________________ | |
| (Name of course or program) | |
| at the | |
| __________________________________ | |
| (Vocational education institution) | |
| beginning | |
| __________________________________ | |
| (Date) | |
| and for payment of tuition by Unified School District No. | |
| __________________________________, | |
| __________________________________, | |
| (County) | |
| Kansas. | |
| __________________________________ | |
| (Student's signature) | |
| __________________________________ | |
| (Date) | |
| __________________________________ | |
| (Parent or guardian's signature) | |
| __________________________________ | |
| (Date) |
| Affidavit of Residency of Applicant | ||
| State of Kansas | } | |
| ____________ County | ss: | |
| I, __________________________________, of lawful age, being first duly sworn on oath say: | ||
| That I am the parent or legal guardian of ______________, a minor, and am a legal resident of Unified School District No. __________, __________________________ County, Kansas, with my post office address being | ||
| _______________________ | ||
| (Street or Route) | ||
| _______________________ | ||
| (City) | ||
| _______________________ | ||
| (State) | ||
| _______________________ | ||
| (Zip) | ||
| and that I have been a resident of said Unified School District | ||
| _______________________. | ||
| (Period of Time | ||
| Further affiant says not. | ||
| ________________________________ | ||
| (Signature) | ||
| Subscribed and sworn to before me this ___________ day of __________, 19_____. | ||
| ________________________________ | ||
| (Notary Public) | ||
| My commission expires | ||
| ________________________________. |
(Authorized by K.S.A. 72-4418; effective, E-71-17, April 5, 1971; effective Jan. 1, 1972; amended May 1, 1979.)