Your child's school must refer the student to the program. You can, however,  complete the Referral by Parent form and the Diversion Program will then contact your child's school to inform them of your request.

Referral by Parent form

Referral by Parent form

Parent Information

Name 

Email 

Phone 

Student Information

Name 

School 

Are there any resources your family needs?

Food Assistance

Utility Assistance

Other 

If "Other," please explain 



Security Measure