Colton Joint Unified School District
HOUSING QUESTIONNAIRE
Grades TK-12
Please complete the following information about your housing. This information will be kept confidential. This document is intended to address the McKinney-Vento Assistance Act under "Every Student Succeeds Act 2015". The answers to this residency information help determine additional services the student may be eligible to receive. A child will not be removed from the child's family solely because the child's family is experiencing homelessness.
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Email *
Student's School of enrollment *
Student's Birthdate *
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Student's Name *
Student's Age *
Current grade *
Parent/Guardian name: *
Current living address: *
Other children living in the home with you: *
Presently, you and/or your family are living in which of the following situations: *
Required
I am a student under the age of 18 and living apart from parent(s) or guardian. *
The undersigned parent/guardian certifies that the information provided above is correct and accurate.
Parent/Guardian name completing this form.
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Date completing this form. *
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Submit
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