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Example Forms and Documentation

Examples of Forms and Documents Created by Districts and Other Agencies

 

Staff Awareness
Community Coordination and Collaboration

Sample Annual Notice

Downloadable posters explaining rights under the McKinney-Vento Act
National Center for Homeless Education (NCHE)

Editable "Know-Your-Rights" Fliers for Parents and Youth
SchoolHouse Connection
We invite you to download and insert your LEA logo, website, and homeless liaison contact information.

Letter to Community Organizations
Parkview School District

Community Networking Breakfast Invitation
Chippewa Falls Area Unified School District

Continuum of Care Meeting Agenda
Fond du Lac School District

Identification and Referral

Homeless Eligibility Flowchart, 2017

Sample Questions to Ask the Students or Parents for Information Gathering

Downloadable brochures explaining rights under the McKinney-Vento Act
National Center for Homeless Education (NCHE)

Forms for District Internal Recordkeeping Purposes

Homeless Student Identification Form for local use
(Fillable PDF) Homeless Student Identification Form for local use

Identification and Transportation for Students 
Middleton-Cross Plains Area School District

Family Data Sheet
Ashwaubenon School District

Self-identification forms (for use during enrollment with families/students)

Families in Transition Questionnaire - English and Spanish
Racine Unified School District

Eligibility Form/Residency Questionnaire
Middleton-Cross Plains Area School District

McKinney-Vento Voluntary Survey
Montello School District

Community Resources

Consent to Release Confidential Information - English and Spanish
Middleton-Cross Plains Area School District

Parents Guide to Community Resources
Milwaukee Public Schools (MPS)
*If you print this document, you must keep all the MPS logos and ads

Community Resource Guide
Durand-Arkansas School District

Community Resource Guide
Clintonville School District

County Resource Guides can also be obtained through UW Extension or local Health and Human Services agencies.

Policies and Procedures
Transportation (To and From School of Origin)

Inter-District Transportation Agreement
Middleton-Cross Plains Area School District

Gas Card Agreement; Gas Card Calculation; and City Bus Pass Agreement
Racine Unified School District

McKinney-Vento Transportation Agreement
Montello School District

Immediate Enrollment

Release of Information Form
Middleton-Cross Plains Area School District

Affidavit Form for Missing Enrollment Documentation
National Center for Homeless Education (NCHE)

Parent Permission to Obtain or Release Information
Dodgeville School District

Sample Caregiver Form
National Center for Homeless Education (NCHE)

Dispute Resolution

Homeless Student Placement Dispute Process
Milwaukee Public Schools

Families in Transition Dispute Process and forms for escalation of dispute - Level 2, Level 3, and Level 4
Racine Unified School District

Student Placement Dispute Process
Ashwaubenon School District


*The DPI EHCY team has received permission from LEAs to post these example forms/documents and received permission for other LEAs to adapt the forms for their own use.