Mcps Form 334 16 PDF Details

Understanding the complexities surrounding informal kinship care and its impact on children's education is crucial. The Informal Kinship Care Status, as denoted in the MCPS Form 334-16, serves as an essential tool within Montgomery County Public Schools, Maryland, to address such situations. This document, developed by the Department of Student Services in April 2007, formalizes the enrollment process for children under informal kinship care, ensuring their educational needs are met despite changes in their living circumstances. With sections to be completed by both the providing relative and school personnel, the form captures critical information ranging from the child's personal details to the specific reasons necessitating informal kinship care—such as the death of a parent, serious illness, drug addiction, incarceration, abandonment, or the assignment of a parent to active military duty. Additionally, it requires verification from a legally authorized individual, ensuring that each case is handled with the utmost integrity and attention to statutory requirements. This form not merely facilitates the continued education of these children but signifies a commitment by Montgomery County Public Schools to provide a stable learning environment for all students, regardless of their personal challenges.

QuestionAnswer
Form NameMcps Form 334 16
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other names334 16 informal kinship care affidavit in montgomery county md

Form Preview Example

Informal Kinship Care Status

MCPS Form 334-16

Department of Student ServicesApril 2007

MONTGOMERY COUNTY PUBLIC SCHOOLS

Rockville, Maryland 20850

Section 1: To be completed by Relative Providing Informal Kinship Care

This is to record that the following child is currently in informal kinship care and is eligible to attend the Montgomery County Public Schools.

Name of Relative Providing Kinship Care

Address

 

 

 

 

Street

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

 

 

 

 

 

State

 

Zip

 

Telephone: (home)

 

-

 

-

 

(work)

 

 

 

-

 

 

-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Student

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Birth Current Grade

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

/

 

/

 

 

 

 

 

 

 

 

 

 

Last School Attended

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Maryland County

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name and Last Known Address of the Child’s Parent/Guardian

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

 

 

 

 

 

State

 

Zip

Authority Legally Authorized to Verify Affidavit Information When Possible (This person must be legally authorized to reveal informa- tion which can verify the assertions in the affidavit.)

Name

 

 

 

 

Position

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

Street

 

City

 

 

 

State Zip

Section 2: To be completed by School Personnel.

Completed and signed affidavit and residency documentation received

Date

 

 

 

/

 

 

/

 

 

 

 

Student ID Number

 

 

MCPS school of enrollment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reason for Informal Kinship Care

 

Documentation Provided

 

 

 

Date

 

 

 

 

 

 

Death of a parent or legal guardian

 

 

 

 

 

 

 

/

 

 

/

 

 

 

Serious illness of a parent or legal guardian

 

 

 

 

 

 

 

/

 

 

/

 

 

 

Drug Addiction of a parent or legal guardian

 

 

 

 

 

 

 

/

 

 

/

 

 

 

Incarceration of a parent or legal guardian

 

 

 

 

 

 

 

/

 

 

/

 

 

 

Abandonment by a parent or legal guardian

 

 

 

 

 

 

 

/

 

 

/

 

 

 

Assignment of a parent or legal guardian to active

military duty

 

 

 

 

 

 

 

 

 

/

 

 

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

/

 

 

 

/

 

 

 

 

 

 

Signature, Relative Providing Informal Kinship Care

 

 

Relationship

Date

 

 

 

 

 

 

 

 

 

 

 

/

 

 

 

/

 

 

 

 

 

 

Signature. MCPS Representative

 

 

Title

Date

 

 

 

 

DISTRIBUTION: ORIGINAL/Cumulative Folder; COPY 1/Relative; COPY 2/Pupil Personnel Worker; COPY 3/Dept. of Reporting and Regulatory Accountability; COPY 4/Residency Compliance Services

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1. Start completing the Mcps Form 334 16 with a selection of essential blanks. Collect all of the required information and ensure nothing is omitted!

Writing segment 1 of Mcps Form 334 16

2. Once this part is complete, you should insert the required particulars in Reason for Informal Kinship Care, Documentation Provided, Date, Death of a parent or legal, Serious illness of a parent or, Drug Addiction of a parent or, Incarceration of a parent or, Abandonment by a parent or legal, Assignment of a parent or legal, military duty, Signature Relative Providing, Signature MCPS Representative, Relationship, Title, and Date in order to proceed further.

Completing segment 2 in Mcps Form 334 16

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