Mosquito Fire Evacuees Educational Support Request
Use this form to request educationally-related supports and services for students and families affected by the Mosquito Fire.
Please note: THIS IS NOT AN EMERGENCY RESPONSE FORM. This form is only monitored Monday through Friday, 8:00am-4:30pm. 
For immediate assistance or assistance with emergency housing and food resources, dial 211 or visit

        Placer County 211: 
        El Dorado County 211: 
For the most up-to-date information on the status of the fire, evacuation shelters, food resources, and more, please visit the Ready Placer site:

For information on age-related reactions to trauma, visit:

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Email *
Contact information for person completing this form (email and/or phone number) *
Are you completing this form for yourself or on behalf of a family/student you are supporting. *
Impacted students name (list all students) *
What county does the student typically reside in (prior to the emergency/disaster)? *
Where does the student typically attend school? *
If child(red) attends school not listed above, indicate school(s) name below:
Student(s) date(s) of birth *
Parent/Guardian/Caregiver's name(s) *
Parent/Guardian/Caregiver's phone number(s)/email(s) *
Current location or address of the student/family *
Current living situation *
Please select the support/service being requested *
Briefly describe how we can help:
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