Blair G. Ewing Center Attendance Form

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This form is to allow students and families the option to attest to viewing a missed live session AND also to request additional services such as technology assistance, counseling services, food and other basic needs. Once you have completed this form an email is sent to directly to the Blair G. Ewing Staff for processing.

The Student/Parent/Guardian must attest to viewing the recorded session by completing this form for each class viewed. If you have questions regarding completing the form or would like to relay this information manually please call the Blair G. Ewing Center at 240-740-5000 for assistance.

Email *

Select the Blair G. Ewing Center where the student attends? *

Type Student's Name (Last, First, Middle Initial) *

Select the Student's Grade *

Student ID number (XXXXXX) *

Select the Date of Absence

YYYY

Select the Virtual Live Course *

Select the Teacher of the Virtual Live Course *

Select the date you watched the Virtual Live course *

YYYY

Type the Full Name of the person submitting this form: (Last, First, MI) *

Select your relationship to the student *

I would like to request support for the following services:

Technology assistance

Counseling Services

Food

Other:

The best way to contact me regarding the request for support for the above mentioned service(s) is:

A copy of your responses will be emailed to the address you provided.

Submit

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