Family Need Survey and Resource Support Form

At Explore Academy - Las Cruces, we are committed to helping every student start the school year ready to learn and succeed. If your family is experiencing any challenges that may impact your child’s ability to fully participate in school, please fill out the form and checkbox below to indicate areas of need that the school can meet for your student(s). We provide support such as assistance with school supplies, uniforms, technology, or any combination of these.

While we always provide the support needed for any child to fully participate in school, this form also helps us to determine if your student qualifies for additional services under the McKinney-Vento Act or other support programs.

All responses are kept private and used only to connect you with available resources.

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Email *
Section 1 - Basic Info
Please provide information about your student. Please fill out one form for each individual student. 
Student's First and Last Name *
Student's Grade Level *
Parent or Guardian Name  *
Parent or Guardian Phone Number
Parent or Guardian Email
Section 2 - School Resource Needs
Please tell us which school resources your student needs.
Please check any school resources your student needs assistant with *
Required
 If applicable, please describe any special circumstances or barriers to education that your family is currently experiencing. 
Section 3 - McKinny Vento Qualifying Questions
 The McKinney-Vento Act provides support to students who lack a fixed, regular, and adequate nighttime residence. You do not have to qualify to request resources, but we would like to identify qualifying students to ensure we are providing the most appropriate resources possible.  Please answer the following questions to help with that identification.
Is your student currently living in any of the following situations?  *
If  "other" was selected on the previous question, please describe the student's living situation in greater detail.
Section 4 - Additional Information
Please provide additional information to help us support your student if desired. 
Are there any challenges your family or student is facing right now that you would like us to be aware of?   Is there anything else you’d like us to know about your situation or how we can support your student?
Do you give consent for a staff member to contact you?
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