McKinney-Vento Notification Form

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Students living in a shelter, motel/hotel due to lack of other accommodation, unsheltered, cars/RVs, transitional housing programs, or doubled up with other people due to loss of housing or economic hardship qualify for McKinney-Vento services. Please fill out this form to notify the Renton School District of a student who may potentially qualify for services.

Email *

Your name (first and last) *

Your contact information *

Relationship to person you are referring *

Self

Family Member

Friend

Community Member

RSD Staff or Partner Organization

Other:

Name of student(s) lacking fixed, regular, and adequate nighttime residence *

Student/Family contact information (if known)

Is student currently enrolled in Renton Schools? *

Yes

Unknown

Student / family living situation

Shelter

Motel/Hotel

Transitional Housing Shelter/Program

Unsheltered (including encampments, cars / RVs, public spaces)

Doubled up in housing of others due to loss of housing / economic hardship

Other:

Clear selection

Address where family is currently staying (if known)

Is the student living in the physical custody of a parent/guardian?

Yes

Other:

Clear selection

Services Needed or Desired

Enrollment

Transportation

Other school items/services

Social service referrals (food, clothes, housing, etc.)

Other:

Comments/Questions

Submit

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