Secondary Instruction (Grades 6-12) - Family Commitment Survey

SLVUSD is planning to reinstate in-person instruction January 2021, under medium restrictions in the Orange Tier.

Medium Restrictions are as follows:

Student groups at 50% of normal size, meaning class sizes are cut in half and only 50% of students are on campus at any given time.
Requires students to maintain social distancing of 6 feet.
Taking student and staff temperatures before entry onto campus each day, as well as completing health screening questions.
Students and staff are required to wear face coverings.
No large group gatherings allowed.
Posting and signage to increase healthy practices like hand washing and wearing face coverings.
Sanitizing and disinfecting protocols for all spaces and buses will be followed.

In Person Instruction - Please Provide the Following Information:

Fill out and submit a separate commitment survey form for each individual student by Friday November 20, 2020.

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1. Student's First and Last Name:

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2. Parent/Guardian's First and Last Name:

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3. Student's School:

San Lorenzo Valley Middle School

SLV Charter Middle School (QHIA, Nature Academy, Coast Redwood Middle)

San Lorenzo Valley High School

SLV Charter Coast Redwood High School

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4. Student's Grade Level:

6th Grade

7th Grade

8th Grade

9th Grade

10th Grade

11th Grade

12th Grade

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5. What is the best daytime contact phone number for Parent/Guardian?

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6. Does your student have an IEP (Individualized Education Program)?

Yes

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7. Please Finish This Statement: If my student's school returns to on-campus instruction...

I want my student to return to the school campus, and I understand the following:
- The in-person schedule will allow students to come to campus to attend classes in-person on a part time basis.
- Students and staff will be required to wear masks.
- On the days or times my student is not attending in-person classes, my student will need to participate and/or complete work online.
- To accommodate in-person and Distance Learning choices, my student may have a different teacher or a change of schedule.

I want my student to remain on 100% Distance Learning, and I understand the following:
- The current Distance Learning schedule may change in order to accommodate in-person instruction and online programs.
- Students will remain in Distance Learning for the remainder of this school year.
- To accommodate in-person and distance learning choices, my student may have a different teacher(s) or schedule.

Secondary Instruction (Grades 6-12) - Family Commitment Survey

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1. Student's First and Last Name:

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2. Parent/Guardian's First and Last Name:

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3. Student's School:

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4. Student's Grade Level:

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5. What is the best daytime contact phone number for Parent/Guardian?

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6. Does your student have an IEP (Individualized Education Program)?

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7. Please Finish This Statement: If my student's school returns to on-campus instruction...

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8. How can the District support your student with returning to on-campus programs?

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9. How can the District support your student in online programs?

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10. Please provide us with additional information you would like us to know.

Secondary Instruction (Grades 6-12) - Family Commitment Survey

Question Title

* 1. Student's First and Last Name:

Question Title

* 2. Parent/Guardian's First and Last Name:

Question Title

* 3. Student's School:

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* 4. Student's Grade Level:

Question Title

* 5. What is the best daytime contact phone number for Parent/Guardian?

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* 6. Does your student have an IEP (Individualized Education Program)?

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* 7. Please Finish This Statement: If my student's school returns to on-campus instruction...

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* 8. How can the District support your student with returning to on-campus programs?

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* 9. How can the District support your student in online programs?

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* 10. Please provide us with additional information you would like us to know.

1. Student's First and Last Name:

2. Parent/Guardian's First and Last Name:

3. Student's School:

4. Student's Grade Level:

5. What is the best daytime contact phone number for Parent/Guardian?

6. Does your student have an IEP (Individualized Education Program)?

7. Please Finish This Statement: If my student's school returns to on-campus instruction...

8. How can the District support your student with returning to on-campus programs?

9. How can the District support your student in online programs?

10. Please provide us with additional information you would like us to know.