Homeless Education Liaison Directory

 


Homeless Education Liaison
Contact Information Submission Form

This form should be completed by all individuals who have been appointed as Homeless Education Liaisons within the State of Texas by their local school district, education service center, or charter school. All information submitted will be verified by the Texas Homeless Education Office (THEO) through the superintendents and executive directors of the educational agencies.

If you have any questions regarding this form or your appointment as a homeless
education liaison, please contact the THEO office.


Local Education Agency Information:

LEA name:

LEA website (URL): http://

Education service center you represent or that your LEA is located in:

School District or LEA county-district number:


Homeless Liaison Information:

First: Middle: Last:

Occupational title:
(i.e.: Title I Coordinator, Parent Liaison, Special Education Teacher, Social Worker, etc.)

Street address 1:

Street address 2:

City:    State: TEXAS   ZIP code:

Area code and phone number: (ex. 5124569878)

Area code and fax number: (ex. 5124569878)

Email address:


Please click this button when you have completed this information to your satisfaction.

Please click this button if you need a blank form so that you can fill out your information form again.