2023-2024 Homeless Unaccompanied Youth Verification
This verification form is to be completed by a McKinney-Vento School District Liason or a director of a HUD-funded or RHYA-funded shelter.
Student Information
First Name
Last Name
Preferred Email
Date of Birth
Street Address
City, State, Zip Code
Home or Cellphone
If no mailing address for the student listed above, please provide name, mailing address, and phone number of current contact.
Name
Street Address
City, State, Zip Code
Home or Cellphone
I am providing this letter of verification as a:
Please select...
McKinney-Vento School District Liaison
Director or designee of a HUD-funded shelter
Director or designee of a RHYA-funded shelter
Name of Shelter
As per the College Cost Reduction and Access Act (Public Law 110-84), I am authorized to verify this student's living situation. No further verification by the Financial Aid Administrator is necessary. Should you have additional questions or need more information about this student, please contact me at the number listed above.
This is to confirm that the student listed above was:
An unaccompanied homeless youth after July 1, 2022. This means that the student was living in a homeless situation, as defined by Section 725 of the McKinney-Vento Act, and was not in the physical custody of a parent or guardian.
An unaccompanied, self-supporting youth at risk of homelessness after July 1, 2022. This means that the student was not in the physical custody of a parent or guardian, provides for his/her own living expenses entirely on his/her own, and is at risk of losing his/her housing.
Agency Signature
Name
Title
Name of Agency
Telephone Number
Email Address
Date
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Contact Information