Contact Information

Shauna Ashmore
Director, Student Support Services
(805) 497-9511 x233
Email

Maria Chavez
Student Support Services
GATE, SARB, Caregiver Authorization, Homeless/Foster Care
(805) 497-9511 x296
Email

Caregiver's Authorization

Caregiver's Authorization Affidavit
To transfer legal duties and responsibilities to a “qualified relative” you will need to fill out the Caregiver’s Authorization Affidavit. It is a multi-page form that requires notarized signatures from the parents, and notarized signature from the custodial adult.  Additionally we need a copy of the caregiver's license, proof of caregivers address (utility bill) and  transcripts from previous school.

Click here for a sample of the Caregiver’s Authorization Affidavit.

Caregiver’s Authorization Forms are available in Pupil Services, District Office and must be approved by the Assistant Superintendent.


Qualified Relative
A qualified relative means a spouse, parent, stepparent, brother, sister, stepbrother, stepsister, half-brother, half-sister, uncle, aunt, niece, nephew, first cousin or any person denoted by the prefix “grand” or “great” or the spouse of any of the persons specified in this definition, even after the marriage has been terminated by death or dissolution.


Notes:
The law may require you, if you are not a relative or a currently licensed foster parent, to obtain a foster home license in order to care for a minor. If you have any questions, please contact your local department of social services.

Students coming from out of the country need an educational VISA.

If the minor stops living with you, you are required to notify any school, health care provider, or health care service plan to which you have given this affidavit.