Student Support Request Form Parent Name Parent Phone Number Parent Email Address Is your current address a temporary living arrangement No Yes - Due to loss of housing or economic hardship. Yes - Some other cause. Which situation(s) best describes your living arrangement In a shelter/group home Doubled up with relatives or friends due to loss of housing or economic hardship Living in a motel, car, campsite, or other inadequate housing Youth living with friends or family members (other than parent/guardian) Select any other needs you need assistance with Food Hygiene products School Supplies Uniforms Number of Students Enrolled at Southgate 0 1 2 3 4 5 6 7 8 Student 1 Informartion Student 1 First Name Student 1 Last Name Student 1 Grade Kindergarten First Grade Second Grade Third Grade Fourth Grade Fifth Grade Sixth Grade Seventh Grade Eighth Grade Ninth Grade Tenth Grade Eleventh Grade Twelfth Grade Student 2 Informartion Student 2 First Name Student 2 Last Name Student 2 Grade Kindergarten First Grade Second Grade Third Grade Fourth Grade Fifth Grade Sixth Grade Seventh Grade Eighth Grade Ninth Grade Tenth Grade Eleventh Grade Twelfth Grade Student 3 Informartion Student 3 First Name Student 3 Last Name Student 3 Grade Kindergarten First Grade Second Grade Third Grade Fourth Grade Fifth Grade Sixth Grade Seventh Grade Eighth Grade Ninth Grade Tenth Grade Eleventh Grade Twelfth Grade Student 4 Informartion Student 4 First Name Student 4 Last Name Student 4 Grade Kindergarten First Grade Second Grade Third Grade Fourth Grade Fifth Grade Sixth Grade Seventh Grade Eighth Grade Ninth Grade Tenth Grade Eleventh Grade Twelfth Grade Student 5 Informartion Student 5 First Name Student 5 Last Name Student 5 Grade Kindergarten First Grade Second Grade Third Grade Fourth Grade Fifth Grade Sixth Grade Seventh Grade Eighth Grade Ninth Grade Tenth Grade Eleventh Grade Twelfth Grade Student 6 Informartion Student 6 First Name Student 6 Last Name Student 6 Grade Kindergarten First Grade Second Grade Third Grade Fourth Grade Fifth Grade Sixth Grade Seventh Grade Eighth Grade Ninth Grade Tenth Grade Eleventh Grade Twelfth Grade Student 7 Informartion Student 7 First Name Student 7 Last Name Student 7 Grade Kindergarten First Grade Second Grade Third Grade Fourth Grade Fifth Grade Sixth Grade Seventh Grade Eighth Grade Ninth Grade Tenth Grade Eleventh Grade Twelfth Grade Student 8 Informartion Student 8 First Name Student 8 Last Name Student 8 Grade Kindergarten First Grade Second Grade Third Grade Fourth Grade Fifth Grade Sixth Grade Seventh Grade Eighth Grade Ninth Grade Tenth Grade Eleventh Grade Twelfth Grade Submit
