Return to In-Person (Hybrid Schedule) Learning Sign-up (Regresar a Aprendizaje en persona Registrarse)

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This form is to be used for students currently on Full-Time remote learning who wish for their child to Return to In Person Learning during the 20-21 School Year (when hybrid in-person instruction is in session). School is open for in person learning on a hybrid schedule identified by Burgundy and Gray teams. You will be contacted with details, schedule information and a return to school date upon the completion of this form. Please complete one form for all children returning to in person learning.

Student Names (nombre del estudiante) *

Grade Levels (nivel de grado) *

Pre-K

Kindergarten

1st grade

2nd grade

3rd grade

4th grade

5th grade

6th grade

7th grade

8th grade

Required

Special Considerations (Consideraciones Especiales)

My child has an IEP or 504 (Mi hija tiene un IEP o 504)

My child is an ELL student (Mi hijo es un estudiante de inglés)

My child sees the Guidance Counselor regularly (Mi hija ve a la consejera regularmente)

I am completing this form because I am requesting to have my child return to in person learning. (Estoy completando este formulario porque solicito que mi hijo regrese al aprendizaje en persona.) *

Yes, I understand and agree. (Si, entiendo y acepto)

Parent or Guardian Name (nombre del padre o tutor) *

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