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Referral for Students who may be Experiencing Homelessness
School-aged children living in unstable housing situations due to economic strain are qualified to receive additional services under the Mckinney-Vento Act. Students that qualify may live in homeless shelters, transitional housing, are doubled up due to economic strain, living in tents, campers, substandard housing, are unsheltered, or are “couch hopping”. If you are working with children who are experiencing homelessness, please use this form to refer them to our district Mckinney-Vento Liaison.
If you cannot fill out the following form to refer a family or to self-identify, please call Becky Carlson at (218) 378-4134
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* Indicates required question
Email
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Your email
Student Last name
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Your answer
Student First Name
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Your answer
Student lives with:
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Father
Mother
Other
Are there other children in the household? Please list names if you have them.
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Your answer
Name of parent/guardians
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Your answer
Address (Please include city)
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Your answer
Phone Number
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Your answer
Services that the family may need:
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Food
Clothing
Monetary Assistance
Housing Assistance (Please follow this link to refer a child who may be experiencing homelessess)
Fuel Assistance
Transportation
Additional Educational Support
Truancy Support
Activity Fees
Safety Issues
Parent Education related to rights/resources
School Clothing/Warm Winter Clothes
Referral for Community Resources
Medical, Dental, other health services
Option 16
Required
Referred by (Optional)
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Your answer
Relationship to Student (Optional)
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Your answer
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