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COVID-19 Survey
Please complete One (1) survey per family
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* Indicates required question
Last Name, First Name (All School Age Students)
*
Your answer
Update Contact Information (Address, Phone Number)
*
Your answer
Grade Level(s) of your child(ren)
*
PK3
PK4
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Required
Do you have internet access?
*
Yes
No
Do you have a technology device? Check all that apply
*
laptop
chromebook
iPad
Desktop
Phone
Other:
Required
Have you or a household family member traveled outside the U.S. in the last 2 weeks?
*
Yes
No
Have you or a household family member traveled outside the state of Texas in the last week?
*
Yes
No
If you traveled outside the U.S. or State of Texas, where did you travel?
Your answer
Have you or a household family member been in direct contact with someone who has been diagnosed with COVID-19 (Coronavirus)?
*
Yes
No
If school is closed beyond March 23, would you pick up free breakfast / lunch for your children enrolled in Kenedy County-Wide CSD?
*
Yes
No
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