2nd Semester Remote Student Intent Headland Middle School

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Dear Parents / Guardians:

In order to properly plan for the 2nd semester, we need you to select which learning option you will be choosing for your child(ren). Please complete this google form no later than November 17, 2020. You will need to complete one form for each student. Students choosing the remote option for 2nd semester must remain remote until the end of the 2nd semester. Second semester begins January 19, 2021 and ends June 4, 2021.

Parent Last Name *

Parent First Name *

Parent Phone Number *

Parent email address

Student Last Name *

Student First Name *

Current Student Grade *

Please select your 2nd semester learning option: *

I choose for my child to return to traditional face to face learning 2nd semester

I choose for my child to continue with the remote option for 2nd semester

ANSWER ONLY FOR STUDENTS RETURNING FACE TO FACE- My child will be a:

Bus rider

Car rider

Clear selection

BUS RIDERS ONLY - Please provide the student's physical address (including street address and city):

Submit

Clear form

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