Student Residency Questionnaire
The information on this form is required to meet the Education for Homeless Children and Youth (EHCY) program, authorized under Title VIIB of the McKinney-Vento Homeless Assistance Act {42 U.S.C. 11431 et seq.), also known as the McKinney-Vento Act.  Presenting a false record or falsifying records is an offense under section 37.10, Penal code, and enrollment of the child under false documents subjects the person to liability for tuition or other cost.  Texas Education Code Sec 25.002(3)(d).

All of the questions that follow refer to the student that is enrolling.
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Email *
Student Name *
Student Grade *
Parent's Name *
Parent's Phone Number *
Check  each box below that best describes where the student sleeps at night.  Leave blank those that do not apply. *
Unsheltered Locations
If you checked unsheltered location above, please select the type of unsheltered location below
Natural Disaster
If you checked Natural Disaster above, please indicate the type of natural disaster below
Name of the Hurricane
Date of the Disaster
Location of the Disaster
Other Information
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