Responses to this form will be kept extremely confidential and limited to the Danville School administration or school counselors. In the case of safety concerns, first responders will be notified as appropriate. The form is checked once daily, on weekdays. If this is an immediate emergency, CALL 911.
What's your name?
How should we contact you? (Phone number, email address, etc.)
What are you in need of?
Food, beyond the lunch program
Cleaning and sanitation supplies (sanitizing detergent and paper towels)
Mental Health Assistance (we will contact you with referrals for community resources)
If this is a request for additional food, please let us know the total number of people in your family.
Once we locate what you need, how can we get it to you?
Deliver it with school lunches
Please find a way to deliver it. I do not receive school lunches.
I can come to the school to pick up items
My request was not for deliverable items.
If you need something brought to you and don't receive school lunches, tell us where to go.
If you feel unsafe in your home, please let us know.
Name/Grade of student(s) - This is particularly important in regards to safety and will help us to know which counselor should reach out to your family.
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This form was created inside of Caledonia Central Supervisory Union.