Current Students

Please Fill Out The Student Residency Questionnaire Below

Student Information

Student Grade

Parent/Guardian Name

Parent/Guardian Phone Number

Living Accommodations

Check each box below that best describes where the student sleeps at night. Leave blank those that do not apply.

Reaquired field: In a home that the student's legal parent/guardian owns or rents

Reaquired field: In a place that does not have windows, doors, running water, heat, electricity, or is overcrouded

Reaquired field: Staying with a friend or relative because of loss of of housing , economic hardship, or a similar reason

Reaquired field: In a shelter

Reaquired field: In an unsheltered location

Reaquired field: In a hotel or motel because of loss of housing or economic hardship

Reaquired field: In a transitional housing program

Reaquired field: The student lives here because of a natural disaster

If you checked unsheltered location above, please select the type of unsheltered location below...

Car or Truck

Van

Abandoned Building

On the street

At a Campground

In the Park

A Tent

In a bus or train station

Natural Disaster

If you checked Natural Disaster in the question above, please indicate the type of natural disaster below.

Hurricane

Flood

Tornado

Wildfire

Name of Hurricane

Date of Disaster

Location of the disaster

Other information

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Required Fields