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Student Assistance Form                                  ***This form is for Inglemoor Families and Students only****
Please fill out this form if you or a student/family you are referring could benefit from assistance with food, clothes, school fees or other basic needs.  Care team will reach out to them and attempt to assist.  This information will be kept confidential.    
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Email *
Name of person filling out form
Student First Name *
Student Last Name *
Is the student eligible for free and reduced lunch?
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Student or Family Email Address 
Student Id if applicable 
Number of Siblings
Graduating Year
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I would like to access the Inglemoor food bank and learn about other resources for food.
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I would like assistance with shoes and clothing.
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I would like assistance with other items.  Please take a moment to describe what you need assistance with.  Inglemoor cannot guarantee that we can meet your request but will work to connect you with other resources. 
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