SLSD 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.  The MV Liaison will meet with the student/family to determine their eligibility. If they qualify, the MV Liaison will help make sure the student can access school, and will provide the student with support navigating systems and connecting to stabilizing resources.
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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.

Thank you!

REFERRAL FORM
My name
My position or how I know the student
School that student attends
Student name (first & last)
Student school ID number (if known)
Student date of birth
Student gender
Clear selection
Is there anything in particular you'd like to share about the student/family 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
Is there anything else you think I should know about the student/family?
What's the best way for me to contact the student/family? (e.g. phone, email, at school)
Are there steps your school has taken to try to meet the needs of the student/family?
Thank you!
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