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Get WA McKinney-Vento Program Intake Form

LL children (Birth through 21 years of age) in your care: (For non-relative caregivers, please list only the children staying with you temporarily) Name Student No. (SSID) Grade Age Date of Birth Current or Last Attended School (if not enrolled, please indicate) Student(s) living situation: D D D Shelter Unsheltered2 Unaccompanied Child or Youth3 1 2 3 D D D D Doubled Up1 Motel/Hotel Migrant Transitional Housing Sharing the housing of other persons due to loss of housing, economic h.

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