UDS Reopening and Remote Learning “Commitment” Form

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In order for UDS to properly plan for the needs of all scholars, we are requiring that parents make a "QUARTERLY COMMITMENT" by July 23rd, 2020 for remote instruction OR in-person instruction. This is a commitment you are making to UDS per quarter. Only extenuating circumstances will allow a change in the commitment and will be handled on a case by case basis with school administration. We have over 180 students on the waiting list so completing your form in a timely manner will secure your seat.

1- Complete ONE FORM per Scholar
2- Complete by July 23rd, 2020

By completing the form, I am signing and acknowledging that I understand I am committing for my scholar to receive instruction based on my selection below. Changes in my commitment will only be addressed due to changing conditions of the pandemic, NCDPI, or NC Gov. requirements, or extreme extenuating circumstances.

COMPLETE A FORM FOR EACH SCHOLAR ENROLLED AT UDS.

Email *

Scholars Last Name *

Scholars First Name *

PARENT Name (Last, First) *

What will your scholar's grade level be at the start of the 2020-2021 school year? (Note: if you will have more than one scholar enrolled in UDS, please complete a form for each scholar.) *

I would like for my scholar to receive the following instructional format at UDS: *

Face-to-Face instruction (during normal school day with COVID-19 safety precautions)

Remote Instruction

I have the technology needed at home for 100% remote instruction. (if needed or if by choice) *

Yes - (a device and internet)

No - (but I will acquire my scholar technology)

No- (I need to borrow a Chromebook from UDS)

My scholar has a medical condition below that makes them "vulnerable" to COVID-19

UDS Staff will review all current plans (e.g., Individual Healthcare Plans, Individualized Education Plans, or 504 plans) for accommodating children with special healthcare needs and update their care plans as needed to decrease their risk for exposure to COVID-19.

chronic lung disease or moderate to severe asthma

heart disease with complications

compromised immune system

severe obesity - body mass index of 40 or higher

other underlying medical conditions, particularly if not well controlled, such as diabetes, renal failure or liver disease

I have a vulnerable immediate family member living in the home

Other:

Clear selection

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

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