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* 1. Please check the buildings in which your children attend. Select all that apply.

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* 2. Please check the grades in which your child will be in the 2020-2021 school year. Check all that apply. 

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* 3. What is your comfort level for your children returning to school?

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* 4. I would prefer to see the following model of instructional delivery when school reopens:

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* 5. My child will ride the school bus when school reopens.

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* 6. Please respond Agree or Disagree to the following statements:

  Strongly Agree Agree No Opinion Disagree Strongly Disagree
Staff should be required to wear a mask.
My child would wear a mask.
My child will not attend if others were not wearing masks.
My child will attend whether or not a mask is required. 
Temperature checks should be conducted.
Internet access is an issue for my family. 

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* 7. When my child eats lunch...

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* 8. Please select one of the following answers...

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* 9. Please respond to the following statements...

  Strongly Agree Agree No opinion Disagree Strongly Disagree
I expect the district to strictly enforce social distancing.
I do not expect the district to enforce social distancing. 
If the district attempts to make some modifications for social distancing, I am comfortable sending my child. 
I understand that the district cannot guarantee social distancing will always occur and I will still send my child to school. 
I will not send my child to school if social distancing is not in place. 

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* 10. Would your answers to any of these questions be different if Lycoming County was in a phase other than green?  Please explain. 

0 of 10 answered
 

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