▢ In an emergency or transitional shelter
▢ Sharing the housing of other persons due to loss of housing, economic hardship, or similar reason
▢ In a motel, hotel, campsite, or car due to a lack of alternative adequate accommodations
▢ In a car, park, public spaces, abandoned building, substandard housing, bus or train stations, or similar settings
▢ Other places not designed for, or ordinarily used as, a regular sleeping accommodations for human beings
▢ Living without running water, heat, or electric service
CONTINUE to the next question if you meet the criteria for any box in SECTION A
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▢ None of the choices in Section A apply.
If you checked this section, you DO NOT need to complete the remainder of this form. Submit the form to school personnel now.
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