Florence County School District Five
PO Box 98 • 156 East Marion Street
Johnsonville, South Carolina 29555
Robert R. Smiley
Superintendent
Phone: (843) 386-2358
Fax: (843) 386-3139
THIS FORM IS REQUIRED TO BE COMPLETED AND RETURNED.
PROOF OF RESIDENCY
STUDENT NAME: _____________________________________________________GRADE: _______________
NEW STUDENT
Prior to enrolling a new student, the following documents should be presented:
1. Birth Certificate
2. SC Certificate of Immunization
3. Social Security Card
4. Withdrawal Form – if student is transferring from another school
5. Proof of Residence – Residency is defined by the Board of Trustees as residing five of seven school nights per
week in this school district (See list below).
RETURNING STUDENT
At least two documents for proof of residency must be presented for returning students. Both must include a
street address and parent’s or guardian’s name. A P. O. Box address is not acceptable. Please attach both
documents to this form.
Please check the two documents presented:
_____Current electricity bill
_____Current gas bill
_____Current water bill
_____Driver’s License or DMV Identification Card with current address
_____Copy of rental or lease agreement on letterhead containing the landlord’s name and phone number
_____Notarized statement from landlord concerning a rental agreement
_____Notarized Proof of Residence Affidavit with whom the student and parent/guardian are residing, along with proof
of residency from that individual (Residence Form 1 is available by visiting our website at www.flo5.k12.sc.us
or the school office)
_____Affidavit (Board Policy JFAA-E) – Anyone wishing to present an affidavit to enroll a student must be referred to the
District Office to complete the necessary form
If the student is a landowner in this district, he/she may enroll without meeting the residency requirement. Tuition for the
school year is required prior to registration. Verification of land ownership will be provided by District Office personnel.
It is necessary that these procedures be followed before any student is enrolled in Johnsonville Schools. These
procedures do not supersede or replace any existing Board policy concerning enrollment of students (e.g. students who
are released from another district and approved by the Board of Trustees or superintendent for enrollment).
Fully Accredited by the Southern Association of Colleges and Schools