Staff Referral Form – Parent Resource Center

PRC Form

PRC Asst. Support

Internet Essential Referral

Newcomer Family Referral

Referral

PRC Assistant Support for MUSD

To request support from the PRC Assistant, please complete the Request Form.

PRC Assistants Can Support With:

✅ ParentSquare or Parent Portal Assistance
✅ Parent Engagement Classes/Workshop Registration
✅ Parent Engagement Classes/Workshop Information
✅ Community Resources Information (e.g., Social Services, Food Banks, Workforce programs, etc.)
✅ Creating a Gmail Account

📌 Turnaround Time: 24 hours
⚡ Urgent Requests: If immediate assistance is needed, please call the Call Center at 559-416-5879 between 8:00 AM - 4:30 PM, Monday-Friday.

For more information or instructions on completing the form, contact Erika Chaidez @ erikachaidezmaderausd.org

Thank you!

Request For Internet Essentials Promo Code/Hotspot (For MUSD Staff To Submit)

(For MUSD Staff to Submit)

The Parent Resource Center (PRC) and the Department of Technology (IT) are collaborating to support MUSD families by providing free internet access. This form allows MUSD staff to submit a request on behalf of families for a Promo Code for Free Internet.

If a family does not qualify for Free Internet, IT will determine if they are eligible for a Hotspot.

Process Overview:

Form Submission – MUSD Staff submits the request.
PRC Contact – PRC staff will reach out to the family to assess their situation.
Promo Code Qualification – If eligible, the family will receive an Internet Essentials Letter with a unique Promo Code and application instructions (in English & Spanish).
Hotspot Request – If the family does not qualify for a Promo Code, they will be added to the Hotspot Request List for IT to review.
Hotspot Approval & Pickup – If approved, IT will deliver the device to the Prices Building, and PRC staff will notify the family when it is ready for pickup.
Transportation Issues – If the family has transportation challenges, please indicate the preferred delivery method in the form.

📌 Turnaround Time: 1-2 days (maximum).
📞 For Assistance: Call the Call Center at 559-416-5879.

Thank you for supporting our MUSD families!

Newcomer Families Referral to PRC

If you are aware of newcomer families entering the district, please refer them to the Parent Resource Center (PRC). Our staff will assist in connecting them to district and community resources to support their transition.

📞 For more information, contact:

Erika Chaidez at erikachaidez@maderausd.org
Call Center: 559-416-5879

Thank you for helping us support our families!

Parent Project & Loving Solutions Referral

Parent Project & Loving Solutions Referral

We are excited to announce that we are now accepting referrals for our evidence-based, community-driven in-person parenting programs: Parent Project and Loving Solutions.

These programs have been proven to:
✅ Reduce family conflict, juvenile crime, recidivism, and high-risk behavior
✅ Increase school performance, home-school communication, and parental supervision

Program Details:

📌 Parent Project – For parents with children in 6th-12th grade (Intervention-Based)
📌 Loving Solutions – For parents with children in K-5th grade (Prevention-Based)

How You Can Help:

We kindly ask for your support in promoting these classes and referring families who may benefit. Once a referral is made, our Parent Resource Center (PRC) staff will reach out to families with a friendly call to:
📞 Encourage participation
📅 Share start dates, times, and locations for the next cohort

Please inform families to expect a follow-up call from PRC.

💙 Your dedication to our students and families is invaluable. Together, we can build a stronger, more supportive community!

For any questions or additional information, feel free to reach out to Brenda Soto @ brendameranzadesoto@maderausd.org

Parent/Guardian Information

First & Last Name

Preferred family's language

Phone Number

Best Time to Contact

Parent Notification

Have you informed the parent/guardian that they are being referred and that they will receive a phone call regarding this referral?

Yes

Please add any comments or helpful information that will help us better serve the family.

Reason for Referral

What concerns or needs does the family have? (Check all that apply)

Information on classes offered by PRC

Access to community resources

Technology support: Parent square, parent portal

Other:

Student Information

Student Name(s) & ID#

School Attended

Please provide additional details about the family’s situation or request

MUSD Staff Information

MUSD Staff First & Last Name

MUSD Staff Email

Department

Select School Site

Parent Information

Parent Name

Contact Number

Select the Reason/s that you are requesting Free Internet/Hotspot

If you know that the Family has transportation issues, please select what delivery method you would like to arrange. Select one option

If your student is enrolled in any of the following programs: Independent Studies (ISP), In-Home Hospital, Homeless Program, or Furman Elementary/High School, those school sites or departments have their own devices for home and school use. Students enrolled in these programs do not need to go through the approval process. Please refer to them for assistance instead of requesting a device.

Student Information

Student Name(s) & ID#

School Attended

MUSD Staff Information

MUSD Staff First & Last Name

Contact Number

Select School Site

OR Department

Parent/Guardian Information

Full Name

Contact number

Preferred language

English

Spanish

Other

Was the family made aware that they will be contacted by our PRC department?

Yes

Comments or helpful information about the family

Student Information

Student Name(s) & ID#

School Student will be attending

MUSD Staff Information

MUSD Staff First & Last Name

Contact Number

Select School Site

OR Department

Referred by: First & Last Name

School Site / Organization

Referred by Email

Referred by Phone Number

MUSD STAFF: Please list ALL Students you are referring (First Name, Last Name and Student ID)

COMMUNITY AGENCIES: Please list ALL Parent Names and Phone Numbers*

Visit our Immigration page for helpful information and services for families. Click here to learn more.

Staff Referrals Forms

PRC Assistant Support for MUSD

Request For Internet Essentials Promo Code/Hotspot (For MUSD Staff To Submit)

Newcomer Families Referral to PRC

Parent Project & Loving Solutions Referral

Parent/Guardian Information

Parent Notification

Reason for Referral

Student Information

MUSD Staff Information

Parent Information

Student Information

MUSD Staff Information

Parent/Guardian Information

Student Information

MUSD Staff Information

Resources

General

Contact

Office

Department of Community Services and Parent Resource Centers