Impact Aid Survey

Impact Aid Form Instructions

Dear Parent/Guardian: 

Varnum Public Schools is entitled to certain federal monies if either mother, father, or guardian of a student is employed on certain federal properties, is on active, full-time duty in the Uniformed Services, or if they live in a Federal Housing Project, or any combination of these requirements. 

To collect this money, Varnum Public Schools must be able to substantiate our claim with the information requested on the back of this form.  


Please complete the entire form with no strikeouts or whiteouts. All boxes must be filled in with complete information if applicable. One form should be filled out for each student who is attending Varnum Public Schools.  

If either parent, guardian, or person acting as a parent is on active duty in the uniformed services as of October  19th, fill in Uniformed Services part of Parent/Guardian Information, and then sign and date the bottom of the form.  

If either parent or guardian is a civilian employed on one of the federal properties listed, fill in the Civilian part of  Parent/Guardian Information, and then sign and date at the bottom of the form. (This includes parents that work for a contractor located on federal property.)  

If either parent or guardian lives in Federal Housing, please check which housing project, and then sign and date at the bottom of the form. 

The information requested is the minimum information required by the Federal Government to receive additional funding for our schools. Your help is needed to obtain these necessary funds, that will provide additional resources for your children.  

Please fill out this form and return it in one of the following ways: Return it in your child’s backpack, drop it off at the school office, or email it to  The form must be dated October 19th or any date after. 


Please fill out the following form.