Skip to content
Skip to content
708 758 5190 (District)
email the district!
201 e. glenwood-dyer rd | glenwood, il 60425
about
Close about
Open about
district 167 report cards
district 167 school board
mission & vision
schools
Close schools
Open schools
brookwood junior high school
brookwood middle school
hickory bend school
longwood school
departments
Close departments
Open departments
curriculum & instruction
food service
technology
resources
Close resources
Open resources
COVID-19 dashboard
Crisis Go
dreambox math
Erin's Law
ESSER Funds
Faith's Law
freedom of information act (FOIA)
Grievance Procedures
lockdown/active shooter drill
medical forms
mental health & SEL resources
PAPER Student Tutoring
Parent/Student Handbook
registration information
Return-To-Learn & Continuing Services
schools meals & nutrition
Section 504 Services
Sexual Health Curriculum
Staff Directory
student health data | immunization
Student Online Personal Protection Act (SOPPA)
student/parent curriculum programs & resources
technology plan
technology usage & conduct policy
title I fund expendtures
title IX training
Attendance & Truancy
Bilingual Groups
Bullying, Intimidation & Sexual Harassment
CHAMPIONS
Parent Resources/Parent Institute
Parent Talk
PowerSchool
Read 180 - Next Generation
administration
Close administration
Open administration
business office
employment opportunities
HR classroom
office of the superintendent
blog
calendar
residency
Student’s Name (Please use the student’s legal name as it appears on their birth certificate)
Powerschool ID
Student First Name
Student Middle Name
Student Last Name
Student Information
Date of Birth
Gender
Please Select...
Male
Female
Grade
Please Select...
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
IEP (Individualized Educational Plan)
Yes
No
504 Plan
Yes
No
With whom does the student(s) reside?
First Name
Last Name
Relationship
Please Select...
Grandmother
Grandfather
Godfather
Godmother
Family Friend
Aunt
Uncle
Cousin
Brother
Sister
Niece
Nephew
Mother
Father
Parent
Addr1
Addr2
City
State
Zip
Best Daytime Phone #
Email
I affirm that the information presented in this verification form, in connection with any investigation of my residency or the residency and custody of the student, is true, complete and accurate.
I understand that knowingly or willfully providing false information to the school district regarding the residency of a child for the purpose of enabling that child to attend any school in that district without the payment of nonresident tuition is a Class C misdemeanor.
I understand that knowingly enrolling or attempting to enroll a child in the school of a school district on a tuition-free basis when I know the child to be a nonresident of the school district, unless the nonresident child has a lawful right to attend, is a Class C misdemeanor and I will be liable for payment of tuition, fees, and all other applicable fines.
I certify to the best of my knowledge that the above information is true and accurate. I understand that if my residency is in question, I may be investigated.
submit the form
