Canyon ISD Unaccompanied Youth Screener 2023-2024
Once this form is completed you will be contacted by the Student Services Department.  If you do not recieve a phone call within 2 business days please call 806-677-2618 to follow up and check the status.
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Email *
Student's First Name *
Student's Last Name *
Grade of Student?  *
Required
Current Campus (Last Campus Attended ) *
Address *
Is your current address a temporary living arrangement?  *
If you were not living here where would you live?  *
Name of the person/s student is living with? *
Where do the student's parent/guardians live? 
 Name of person filling out form?  *
Relationship to student? (If student, indicate "self".)
Date *
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Phone Number *
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