STATE OF SOUTH CAROLINA
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)
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PUBLIC
SCHOOL
ENROLLMENT
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AFFIDAVIT
COUNTY OF ______________
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(S.C. Code Ann. Section 59-
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63-32)
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This affidavit is submitted pursuant to Section 59-63-32 of the South Carolina
Code of Laws to confirm the qualifications for enrollment set out in Section 59-
63-31(A)(1)(c) for a child residing, as a result of specific circumstances, with
an adult resident of the school district who is not a parent or legal guardian
of the child; and to confirm the additional requirements of Section 59-63-32
including acceptance of responsibility for educational decisions for the child.
PERSONALLY appeared before me, ___________________________________________
who being duly sworn states:
1.
I am an adult resident of __________________________________________
school district, residing at: _________________________________________________.
2.
The child, _________________________________________________________
has resided with me since _____________________________________________________.
The child’s relation to me is _________________________________________________.
3.
The child resides with me as a result of:
_____ a.
the death, serious illness, or incarceration of a parent or
legal guardian;
_____ b.
the
relinquishment
by
a
parent
or
legal
guardian
of
the
complete control of the child as evidenced by the failure to
provide substantial financial support and parental guidance;
_____ c.
abuse or neglect by a parent or legal guardian;
_____ d.
the physical or mental condition of a parent or legal guardian
is such that he or she cannot provide adequate care and
supervision of the child;
_____ e.
a parent’s or legal guardian’s homelessness, as that term is
defined by Public Law 100-77; or