COVID Remote Instruction Request
Please remember that this is a request and that this form does not activate remote instruction. After completion of this form, the school will need 1-3 days to process the request and allow teachers to prepare for remote instruction.

 By completing this form, the student will be out for ten (10) calendar days. Should questions or negative test results arise, please contact the nurses' office.
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Email *
Child's Grade *
Student Last Name *
Student First Name *
Student ID# *
My child tested positive for COVID. *
If yes, date of positive test result.
Reason for requesting remote instruction (these can only be for COVID related items). Check all that apply. *
Required
I understand that there will be a waiting period of 1-3 days to begin live temporary remote learning. *
I understand that by completing this form, my child is not able to participate in activities and/or sports while on remote instruction. *
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