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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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.
Completing the form for myself or my child(ren) or family
Completing the form for someone else (and I work for a local school district or agency)
Impacted students name (list all students)
What county does the student typically reside in (prior to the emergency/disaster)?
El Dorado County
Where does the student typically attend school?
Foresthill Divide K-8
Foresthill High School
iLEARN (Pathways Charter)
Another school in Placer County (list below)
Another school in El Dorado County (list below)
If child(red) attends school not listed above, indicate school(s) name below:
Student(s) date(s) of birth
Parent/Guardian/Caregiver's phone number(s)/email(s)
Current location or address of the student/family
Current living situation
Evacuation Shelter (Sierra College)
Other Shelter (The Gathering Inn)
Shared housing (staying with another family/relative)
Car/Vehicle/Trailer (NOT in a designated hook-up spot)
Trailer park/ RV park
Please select the support/service being requested
Assistance with accessing school district resources
Assistance with locating food, clothing, and other basic needs
Connection to mental health/emotional supports
Tangible items (e.g. backpacks, school supplies, coloring and art supplies, hygiene items)
Assistance with accessing childcare
Briefly describe how we can help:
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This form was created inside of Placer County Office of Education.