McKinney Vento Homeless Assistance Act Referral Form

Are you experiencing:  

  • Unsafe or unhealthy housing due to fire, flood, mold or utility shut off?
  • Unsafe or unhealthy housing due to domestic violence?
  • Lack of housing due to eviction, red tag, or other situation?
  • Lack of housing due to being kicked out?
  • Lack of your own housing (staying with another person or family in their home)?
  • Or residing in a car/vehicle, shelter, or tent?

*Information is confidential. The McKinney Vento Homeless Assitance Act follows federal FERPA privacy rules and regulations.

Are you a student, parent, or care giver for a student?   (required)
What is a good way to contact you?   (required)
Are you or your children currently receiving supports from the Homeless Assistance Program?   (required)
Where did you spend last night?   (required)
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