CUSTODY AGREEMENT/COURT ORDER REGISTRATION FORM

CUSTODY AGREEMENT/COURT ORDER
REGISTRATION FORM
The Commonwealth of Pennsylvania requires this information for newly registered students:
1. Is the student a:
Minor
2. Is the student a single parent?
Adult
Emancipated Minor
Yes
No
In case of divorce or separation, please provide information regarding custody agreements and/or court
orders:
1. Is there a custody agreement or court order?
Yes
No
2. Do we have a copy of that agreement or order on file?
Yes
No
3. Who has physical custody?
Mother
Father
Joint
4. Who has legal custody?
Mother
Father
Joint
5. Does the child reside in Penn-Delco School District seven (7) days per week?
Yes
If not, please explain:
Parent/Legal Guardian Signature:
Person completing this form (If other than parent/legal guardian):
DISTRIBUTION: Residency File, School secretary
Date:
No