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* 1. What grade will your child be in this school year? (If you have more than one child, please check multiple grade levels.)

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* 2. Which of the following statements most closely reflects your choice about your child returning to school on July 29th:

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* 3. If you will be sending your child back to school what preventative measures would you like to see in place?

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* 4. If you will not be sending your child to school what is the primary reason?

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* 5. Other comments or suggestions?

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