Hurricane Laura Displacement Questionnaire

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If your family was displaced due to Hurricane Laura, please complete this questionnaire. This will be used for us to address the needs of your family as it relates to school enrollment purposes in to the Vermilion Parish School System.

Client's First and Last Name: *

Are you: *

Parent (Birth Certificate Parent)

Legal Guardian (Court order signed by a judge)

Caregiver (Providing care but no legal rights to the child)

Unaccompanied Youth (Child not living with their birth parent)

Contact Phone Number: *

Contact Email: *

Where are you currently living (full street address, city, and state)? *

If this is not your home, please give a brief description of why you are currently living there? *

If you are a caregiver, please explain why the child/student is living with you? *

Emergency Contact for you (name and phone number): *

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