Section 92-19-012 - FormsIncluded as appendices to this Chapter are two forms.
012.01 Adult with Legal or Actual Charge or Control of a Student Form (Appendix A) This form is to be used by a district for purposes of Section 79-215(13) R.R.S., which provides, in part, that:
(13) On a form prescribed by the State Department of Education, an adult with legal or actual charge or control of the student shall provide the name of the student, the name of the adult with legal or actual charge or control of the student, the address where the student is residing, and the phone number and address where the adult may generally be reached during the school day. If the student is homeless or if the adult does not have a phone number and address where he or she may generally be reached during the school day, those parts of the form may be left blank and a box may be marked acknowledging that these are the reasons these parts of the form were left blank. The adult with legal or actual charge or control of the student shall also sign the form.012.02 Sample Power of Attorney Form (Appendix B) This sample form is a power of attorney delegating powers of a parent under Section 30-2604 R.R.S. This form is included as a sample for adults in legal or actual control of a child who may find a form of this nature useful in specific situations. No person or district is required to use this form, or any power of attorney form, nor can a district mandate its use as a condition for enrollment of a child. Such a power of attorney may be effective for six (6) months at a time, although a new power of attorney may be created upon its expiration. It is recommended that a person consult their own attorney before using any legal form.
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92 Neb. Admin. Code, ch. 19, § 012
Amended effective 6/6/2017.