Get Intake Form - Berks County Intermediate Unit - Berksiu

Filling out the Intake Form for the Berks County Intermediate Unit is an important step in ensuring that students experiencing homelessness receive the support they need. This guide offers clear and detailed instructions to help you complete the form accurately and efficiently.

Follow the steps to successfully complete the Intake Form online.

1. Press the ‘Get Form’ button to access the Intake Form and open it for editing.
2. Begin by entering the name of the parent or guardian responsible for enrolling the student in the designated field.
3. Provide the relationship of the guardian to the student in the corresponding section.
4. Fill out the complete address of the family, including street, city, state, and zip code.
5. Enter a contact number where the parent or guardian can be reached.
6. Indicate the school district the student is enrolled in.
7. Specify the school building where the student is attending.
8. Complete the student’s name, date of birth, grade, and Pennsylvania Student ID number in the respective fields.
9. List the number and names of other schools or districts the student attended in the current school year.
10. Indicate whether a school uniform is needed by circling 'YES' or 'NO'.
11. If applicable, provide specific pant and shirt sizes for the school uniform.
12. Specify any requests for books, bags, or supplies needed by the student.
13. Indicate whether a bus pass is needed.
14. Select the appropriate living arrangement for the student by checking the relevant box.
15. If applicable, provide the name of the emergency shelter, hotel/motel, or transitional program.
16. Fill in the section regarding transportation to the school of origin, including the mode of transport provided.
17. Enter any necessary additional comments or notes in the provided section.
18. Confirm the accuracy of the residency information by having the parent or guardian sign and date the form.

Complete the Intake Form online today to ensure timely support for your child.