JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Staff Self-Certification
Please complete this form PRIOR to entering the building. (Close Contact question on 2nd page)
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Please add in your email address.
*
Please enter your HILLSIDE #93 email address.
Your answer
FIRST Name
Your answer
LAST Name
Your answer
I have taken my temperature today and my temperature is below 100.4.
*
Yes / Si
No
Do you have any of the following symptoms?
*
Yes/Si
No
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Hillside District 93.
Report Abuse
Forms
