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FSK Eligibility Form
Please fill out form as it will help us determine if you qualify for FSK services.
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* Indicates required question
Email
*
Your email
First and Last name of Deaf/Hard of Hearing (DHH) Child
*
Your answer
Please choose one of the following:
*
My child is Deaf.
My child is Hard of Hearing.
DHH Child's Date of Birth
*
MM
/
DD
/
YYYY
Name of School DHH Child attends (If they do not attend school yet you can type NONE, otherwise please type in the name of the school which includes preschool.)
*
Your answer
Parent's names of DHH Child
*
Your answer
Full address of DHH Child
*
Your answer
Name of County where DHH Child lives
*
Your answer
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