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McKinney-Vento Program Application

Do you qualify to receive services under the McKinney-Vento Act?

Please visit your child’s school and ask for the school’s homeless liaison to complete the necessary documentation, or complete the student residency form here. Once it has been submitted, you will be contacted in 2-3 business days.

Parent/Guardian or Unaccompanied Youth Information
Please enter the name of the parent/guardian completing this form out.
Please enter the email address of the parent/guardian completing this form.
Please enter a valid phone number for the person submitting this form.
Please provide the name of the shelter, hotel address, or location of where you slept last night.
Please choose the preferred methods of communication. (Check all that apply.)
Student Information
Please select the school of the student in need of assistance.
Please select the student's gender.
Please enter the student's current age.
Please select ethnicity of the student.
Please indicate whether the student has an IEP.
Does the student have reliable transportation?
Please indicate whether you have another student living in the household.
Student 2 Information
Please select the school of the student in need of assistance.
Please select the student's gender.
Please enter the student's current age.
Please select ethnicity of the student.
Please indicate whether the student has an IEP.
Please indicate whether you have another student living in the household.
Student 3 Information
Please select the school of the student in need of assistance.
Please select the student's gender.
Please enter the student's current age.
Please select ethnicity of the student.
Please indicate whether the student has an IEP.
Please indicate whether you have another student living in the household.
Student 4 Information
Please select the school of the student in need of assistance.
Please select the student's gender.
Please enter the student's current age.
Please select ethnicity of the student.
Please indicate whether the student has an IEP.
Family Situation
Is your family in need of any of the above? (Please check all that apply.)
Where is the student or students living right now? (Select only one.)
Please indicate the primary reasons for homelessness. (Please check all that apply.)
Please explain the circumstances that lead to your homelessness.
Declarations
Please enter the last date of permanent residency.

I declare that I am EITHER the parent/legal guardian of the student(s) named above who is/are of school age and is/are seeking enrollment in the Huntsville City School System, OR I am an unaccompanied homeless youth who is of school age and is seeking enrollment in the Huntsville City School System.

Please select yes or no to affirm the above statement.

I understand that by clicking SUBMIT below, and under penalty of perjury under the laws of this state, I declare that the information provided here is true and correct and of my own personal knowledge and that, if called upon to testify, I would be competent to do so.

Please select yes or no to affirm the above statement.
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