102 Loralee Drive
Albany, New York 12205
C E N T R A L S C H O O L D I S T R I C T
(518) 869-3576 ext 0454
1(833) 961-1185
McKinney–Vento Assistance Act
The McKinney–Vento Assistance Act of 1987 is a federal law that provides money for homeless shelter programs.
_South Colonie Schools_____________
Where is the student currently living? (Please check one given below.)
In an emergency or transitional shelter
With another family or other person due to loss of housing or economic hardship
With an adult who is not a parent or guardian or alone without an adult
In a hotel/motel
In a car, park, bus, train, campsite, public place, abandoned building
Other temporary living situation (Please describe) _______________________________
Date _____________________
_________________________________ ________________________________________
of Parent, Guardian, or Student
________________________________
________________________________
Address: __________________________________________ Phone _____________
of Parent, Guardian, or Student
If the student is NOT living in permanent housing, please ensure that a Designation Form is completed.
No, the student is residing in permanent housing.
If the student is not living in permanent housing, proof of residency and other documents
normally needed for enrollment are not required and the student is to be immediately
enrolled. After the student has been enrolled, the district/school must contact the
previous district/school attended to request the student’s educational records, including
immunization records, and the enrolling district’s LEA liaison must help the student get
any other necessary documents or immunizations.
Date of Birth _____/_____/ _______ Grade _______
Tuesday, September 27, 2016