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OUT-OF-STATE STUDENT & STAFF TRAVEL RETURN FORM
This form must be completed for each member of the SACS school community who has traveled out of the Commonwealth of PA for longer than a 24-hour period.
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Email
*
Your email
Student/Staff Name:
*
Your answer
Student Grade/ Staff Position:
*
Your answer
Date Departed PA:
*
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YYYY
Date Returned to PA:
*
MM
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I certify that the following statements are true of COVID-19 Test and Quarantine Status:
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Above-named student/staff travel quarantined for 10 days without testing or quarantined for 7 days and received a negative result after Day 5 upon return from travel outside the Commonwealth of PA.
Student/Staff did not test positive for COVID-19 during travel quarantine.
Student/Staff had no (and currently does not have) COVID-19 symptoms.
Required
If a COVID-19 test was taken, please provide the date of the negative result received. A hard copy of results must accompany the student upon return to school.
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