Special Needs Form

Carl Junction Schools

Storm Shelter

Special Needs Form

The Carl Junction School District invites community members to use the High School storm shelter when severe thunderstorm or tornado warnings are issued. If you have special needs that we may be able to accommodate, please complete this form and submit it to:

• Kyle Williams, Assistant Superintendent for Operations
• Carl Junction School District
• 206 S. Roney
• Carl Junction, MO 64834
• Fax (417) 649-6594

The district will attempt to accommodate your special needs with the limited staff, which does not include medical professionals. Also, the district cannot provide transportation to and from the shelter.

Name: __________________________________________________

Street Address: ___________________________________________

City:______________________ State:_________ Zip Code:________

Phone:_____________________ Email:________________________

Emergency Contact:_____________________________ Phone:________________

Please list special needs: ________________________________________________________  ___________________________________________________________ _____________________________________________________ ________________________________________________________

* Service animals, such as Seeing Eye dogs, are welcome.  Please bring appropriate certification.