Douglas County School System Homeless Education Program

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

If your family lives in any of the following situations:
• In a shelter
• In a motel or campground due to the lack of an alternative adequate accommodation
• In a car, park, abandoned building, or bus or train station
• Doubled-up with other people due to loss of housing or economic hardship (ex. evicted from home, etc.)

Then your school-age children may qualify for certain rights and protections under the federal McKinney-Vento Act for the 2023-2024 school year.

Looking for resources? Visit the DCSS Student Support Services website at

https://sites.google.com/dcssga.org/wraparound-services-resource/dcss-services-and-resources or contact 2-1-1 by calling or visiting http://211online.unitedwayatlanta.org/.

Date *

YYYY

Name *

Phone number *

email address *

Student name(s) and school(s) attending *

Immediate needs or services requested:
*

Free Lunch

School Supplies

Tutorial/Supplemental Instruction

After-school Program

Transportation assistance for school

Enrollment/Placement Assistance

Records Assistance

Immunizations/Medical

Assistance with additional resources

Other:

Required

QR Code of this Form

https://docs.google.com/forms/d/e/1FAIpQLSd0QULiMBmTtbCoC8PgIP47vxOeDqb-kYGZ_zv7Bd9qggcJpw/viewform

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Douglas County School System. Report Abuse

Forms