Residence Assessment
Academic School Year
** Please Select **
2024-2025
Enrolling Parent/Guardian/Caregiver
Address
City
State
** Please Select **
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Puerto Rico
Virgin Islands
ZIP
Contact Number
Relationship to Student
** Please Select **
AUNT
BROTHER
BROTHER IN LAW
FIANCE
FOSTER FATHER
FOSTER MOTHER
FRIEND
NEIGHBOR
NEPHEW
NIECE
SIGNIFICANT OTHER
COUSIN
SISTER IN LAW
DOCTOR - Type
EMERGENCY CONTACT - Type
LEGAL GUARDIAN
Household Member
NA
Spouse
Son
Parent
Placement Provider (Tuscaloosa County DHR)
Mobile DHR social worker
Legal Guardian
Great Grandmother
Godmother
Granddaughter
Daughter
Unaccompanied Youth
Godfather
STEP BROTHER
STEP SISTER
FATHER
MOTHER
STEP FATHER
STEP MOTHER
GRANDFATHER
GRANDMOTHER
CAREGIVER
CASE WORKER
SISTER
SOCIAL WORKER
UNCLE
Enrolling Parent/Guardian/Caregiver Email
Legal Guardian
Address
City
State
** Please Select **
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
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
Zip
Contact Number
I am seeking to enroll due to the following reason(s): (check all that apply)
Student's parent/legal guardian is incarcerated/in jail
Student's parent/legal guardian is in military on deployment
Student was placed with me by an agency (DHR, DYS, etc)
I have petitioned the court for legal custody
I am a student who is NOT living with a legal parent/guardian
I am living in a temporary housing situation
Other
Other Description
Please explain the current situation (living, custody, etc.):
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