Student Housing Questionnaire
The answers to the following questions can help determine the services this student may be eligible to receive under the McKinney-Vento Act 42 U.S.C 11435. The McKinney-Vento Act provides services and supports for children and youth experiencing homelessness. Please see the page on our website that helps to define homelessness, according to the McKinney-Vento Act. If the student lives in a home owned or rented by the parent or guardian, you do not need to fill this out unless there are inadequate facilities (no water, heat, electricity, etc.)
If the student does not live in a home owned or rented by the parent or guardian, please check all that apply below.
*
Transitional Housing
In someone else's house or apartment with another person/family
In a motel
Moving from place to place/couch surfing
In a shelter
A car, park, campsite, or similar location
In a residence with inadequate facilities (no water, heat, electricty, etc.)
Other
Name of Student (First and Last)
*
Which school does the student attend?
*
Please Select
Monte Cristo Elementary
Mountain Way Elementary
Granite Falls Middle School
Granite Falls High School
Crossroads High School
Open Doors
Pre-School at Monte Cristo Elementary
What grade is the student in?
*
Please Select
Pre-School
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Student's Birthdate (Month/Day/Year)
*
Student's Age
*
Is the student Unaccompanied?
*
Student IS unaccompanied (not living with a parent or legal guardian)
Student IS NOT unaccompanied (is living with a parent or legal guardian)
Address of current residence
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Who can we contact?
*
Phone number of contact person
*
Please enter a valid phone number.
Does the student have siblings living at this same address that also attend Granite Falls School District? If yes, please list the names below.
Thank you for taking the time to fill out the Student Housing Questionnaire. Once you hit submit, it will be submitted to Cassidy Fouts, the McKinney-Vento Coordinator. She should reach out by phone in the next three days. If you have any questions in the mean time please feel free to reach out to her at 360-283-4506 or by email at cfouts@gfalls.wednet.edu.
Submit
Should be Empty: