GREGORY TRAVEL NOTIFICATION FORM

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Please complete this form to notify us of a student's travel outside of New Jersey or our accompanying states, such as Pennsylvania, New York, Delaware, and Connecticut. Once this form is submitted, you will receive an email from your building principal, Ms. Hewitt, with a confirmation of receipt and the student's approved date for return to in-person instruction.

Student's Name *

Homeroom Teacher *

Travel Destination: *

Dates of Travel (Date Leaving Home - Date Returning Home) *

Is your child vaccinated? (Please make sure our Health Office has the records on file.) *

Yes

Name of Parent/Guardian Completing this Form *

Email Address *

Submit

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