Brookwood 167

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[Proof Of Residency] form must be completed by the parent/guardian enrolling a new student in the district for the upcoming school year. Only one form per family is required. Please review this form carefully and be prepared to show documentation that proves your child’s residency in the district. The document that you use from Category 1 must display your current address in the district. P.O. Boxes will not be accepted.

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[Community Eligibility Option (CEO) Application Form Regarding Free Breakfast | Lunch]

Brookwood School District 167 is participating in the Community Eligibility Option (CEO) provision under the National School Lunch Program. Under CEO, all children in the District will receive a breakfast/lunch at no charge regardless of income or completion of the the form (below). However, to determine eligibility for various additional state and federal benefits that your child(ren) may qualify for, please complete, sign and return this application during the registration process.

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[Acknowledgement Of Responsibility] form should only be completed by those parents/guardians who “ARE NOT” able to produce the required documentation to establish residency in the district. This form is to be completed by the Parent/Guardian of the child and the owner of the residence. This form is completed in conjunction with the [Affidavit Of Residence] form. Please keep in mind that Public Act 89-480 specifies penalties for fraudulent registration of a student as a Class C misdemeanor with potential penalties of up to 30 days in county jail or a $1500.00 fine or one year of probation for the parent/guardian and owner of the home.

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[Affidavit Of Residence] form, should only be completed by those parents/guardians who “ARE NOT” able to produce the required documentation to establish residency in the district. This form must be signed by the parent/guardian and homeowner and notarized. [Affidavit Of Residence] form is completed in conjunction with the [Acknowledgement Of Responsibility] form. Please keep in mind that Public Act 89-480 specifies penalties for fraudulent registration of a student as a Class C misdemeanor with potential penalties of up to 30 days in county jail or a $1500.00 fine or one year of probation for the parent/guardian and owner of the home.

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– BJHS ONLY –

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