BRIDGEWATER-RARITAN REGIONAL SCHOOL DISTRICT
836 Newmans Lane, P.O. Box 6030, Bridgewater, NJ 08807
AFFIDAVIT OF DOMICILE FOR STUDENT AND PARENT/GUARDIAN
RESIDING IN THE HOME OF ANOTHER PERSON
DIRECTIONS: Complete this form in the presence of a notary public and return original to the Attendance Officer in the
Department of Student Personnel Services for filing with the Board Secretary, in accordance with N.J.S.A. 18A:38-1.
To Be Completed By The Parent/Guardian:
I hereby make application for the enrollment of _______________________________________ (date of birth)_____________ in
grade__________ of the ___________________________________________ School. This student previously attended
_________________________________________School in ___________________________________________________.
The student and parent/guardian reside at the following address: