Housing Security Form
The McKinney-Vento Homeless Assistance Act is a federal law created to support the enrollment and education of homeless or housing insecure students. McKinney-Vento is intended to provide homeless students the same educational opportunities as housed students by removing as many barriers to learning for homeless students as possible.

Please complete this form if you are currently experiencing or fear housing insecurity in the near future.  You will receive a follow up phone call within a few days. 

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Name of person completing the form:
Last Name: *
First Name: *
Best phone number to be reached: *
Student Name
Last Name of Student: *
First Name of Student: *
School Name: *
Grade: *
What type of assistance would benefit your family's needs?  Please check all that describe your needs.
Are you experiencing housing insecurity right now?
How long have you been housing insecure? Days/Weeks/Months/Years
What is the address where you are currently staying? 
What is your current housing status?
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Please check below if you could also benefit from food/clothing assistance.
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