JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
COVID-19 Student Report Form
Parent/Guardian of a current WCS student is encouraged to notify the school within 24 hours if their child has tested positive for COVID-19 or has been clinically diagnosed with COVID-19.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
PARENT: First and Last Name
*
Your answer
Please provide a phone number for follow-up questions:
*
Your answer
Your email (optional)
Your answer
STUDENT: First and Last Name
*
Your answer
Student/Staff Building, Department, and/or Activity:
*
Denver Place
East End Preschool
Holmes Elementary
Wilmington Middle School
Wilmington High School
Other:
Student's Grade Level
*
Choose
Preschool
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Has the student participated in any WCS extracurricular activity this school year(ie, athletics, marching band, etc)?
*
Yes
No
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Wilmington City Schools.
Report Abuse
Forms
