Confidential Information
Complete this form if it reflects your child's current living situation
Check the one(s) that best describes the student's living situation:
In a shelter
With relatives or others due to lack of housing
In a motel/hotel, camping ground, or other similar situation due to the lack of alternative, adequate housing
In an abondoned apartment/building
Temporarily housed in a shelter awaiting a DCFS permanent foster care placement.
By Iowa law, the school will need a copy of the following legal documentation to put in your child's folder if you mark yes to any of the below items:
Joint Custody Ruling: If there is a joint custody ruling, the non-custodial parent must directly contat their child's attendance center at the beginning of each school year to be placed on their mailing list to receive progress information.
Yes
No
Order of Protection
Yes
No
No Contact Order
Yes
No
Student Name
Your answer
Student Grade
Your answer
Name of parent completing form
Your answer
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