JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Request for Resources
Hello, I'm Christine Kroeze your School Social Worker at Glacier Hills Elementary. I'm here to offer support, connection and partnership. If you find yourself in need of community resources or mental health support below are websites that offer information.
--
https://www.co.dakota.mn.us/HealthFamily/HandlingEmergencies/Disasters/Pages/community-resources.aspx
--
https://www.211unitedway.org/
--
https://www.district196.org/about/back-to-school
If you continue to have questions, please complete this request and I will contact you by phone or email (indicate your preference below). If you would like to contact me directly please email at
christine.kroeze@district196.org
or call (651)683-8570
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Resource information
Food
Housing/Eviction
Health Insurance
Emergency Dental
Internet/Cell Services
Unemployment
Domestic Violence (If there is an immediate safety concern call 911)
Mental Health (If there is an immediate need call 911/Dakota County Crisis Response (951)891-7171
Grief and Loss information
School Supplies
Other:
Clear selection
Parent/Guardian Name
*
Your answer
Student Name(s)
*
Your answer
Parent/Guardian Phone Number
*
Your answer
Parent/Guardian Email Address
*
Your answer
Preferred Type of Contact
*
Email
Phone
Any other questions?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Independent School District 196.
Report Abuse
Forms