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Creswell McKinney-Vento Referral Form
Children and youth experiencing homelessness face unique challenges in accessing and succeeding in school. The McKinney-Vento ("MV") Act helps remove barriers so that students can be more successful.

Please fill out this form to refer a student to the MV Program. Sarah Stephens, the new MV Liaison, will meet with the student/family to determine their eligibility. If they qualify, Sarah will help make sure the student can access school, and will provide the student with support navigating systems and connecting to stabilizing resources.

sstephens@creswell.k12.or.us
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Who is eligible to receive support from a McKinney-Vento Liaison?
As a general rule of thumb, if you believe a student might not be permanently housed, please fill out this referral form. We want all eligible students to get help, so please err on the side of over-referring. Students are eligible if their housing situation isn't fixed, regular or adequate. Examples of living situations include: living in a trailer, staying with others (extended family/friends) due to financial hardship, living in a motel/hotel, living in substandard housing (electricity or water turned off), sleeping in a vehicle, tent, RV, or public space. Youth who no longer live with their family and/or are living on their own may also qualify.
Referral Form
Referring Person
My position or how I know the student:
School that the student attends:
Student's name (first & last):
Student school ID number (if known):
Student's gender:
Clear selection
What is known about this student/family's housing situation?
Do you think the student might be living without their parent or guardian (i.e. unaccompanied)?
Clear selection
Preferred language of student/family;
What is the student/family's preferred form of contact? (e.g. phone, email, at school)
What steps have already been taken to support this student/family?
Thank you!
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