JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Seeking Assistance
Please complete the form when you are in need of assistance. Thank you.
* Indicates required question
Name
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
Are we able to text to the phone number listed?
*
Yes
No
If you have a PUSD student, please list their name, Student ID #, School Site, and grade below. i.e. John Doe, 552233, Mohr, 4 or state NA - Not applicable
*
Your answer
Please let us know why you are reaching out.
*
Foster Youth are children and youth who are currently under the jurisdiction of Juvenile Court due to abuse and or neglect by a parent or caretaker. Foster Youth are placed in a licensed foster home. This placement may be with a relative, close family friend or a stranger.
Kinship Youth are children and youth who are currently living in the home of someone other than their biological or legal parent (adoptive/step). Kinship Caregivers may have Legal Guardianship of the child/youth through Probate Court or in most cases here in Pleasanton, the arrangement is unofficial.
McKinney-Vento (MKV) is a Federal Law protecting the access to a public education when a student experiences changes to their living situation that results in homelessness.
General Resources
Graduate Masters of Social Work Internship
Other:
Required
Additional Information
*
Your answer
We are currently out on Summer Break and will return on August 13, 2026. If there is an immediate need, please reach out to Student Services at (925) 426-4290. We will reach out to you within a week of the 2026-2027 school year. Thank you.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Pleasanton Unified School District.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report