Fallsburg Central School District COVID-19 Home Test Kit Request Form (Solicitud para el kit de prueba casera de COVID-19 del Distrito Escolar Central de Fallsburg)

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Please use this form to request an at-home COVID-19 testing kit. Please fill out this form one time for each of your children. (Utilice este formulario para solicitar un kit de prueba de COVID-19 en el hogar. Complete este formulario una vez para cada uno de sus hijos.)

Email *

School (Escuela) *

Benjamin Cosor Elementary School (Escuela Primaria Benjamin Cosor)

Junior Senior High School (Escuela secundaria/preparatoria)

Student Last Name (Apellido del estudiante) *

Student First Name (Nombre del estudiante) *

Student Grade Level (Nivel de grado escolar) *

Pre-K

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