Please submit one survey response for each of your students.

Dear Parent/Guardians:

Campbell Union School District will open with full-day, in-person learning for all grades on August 19th. We are following all required public health protocols in order to maintain safe learning environments for students and staff. 

A new law about Independent Study in the 2021-22 school yearCalifornia AB 130—also authorizes us to provide Independent Study for a student whose health would be put at risk by in-person instruction, as determined by the parent or guardian. The independent study program will meet all of the legal requirements for educational progress, grade-level standards, synchronous instruction, student engagement, and transitioning back to in-person instruction within 5 days if the parent/guardian determines that the health risk is no longer an issue. The program is required for the 2021-22 school year only.

Campbell Union School District will be providing the independent study option for students whose health would be put at risk by in-person instruction, as determined by the parent or guardian. 

In order to determine how many students may require independent study due to personal health risks, we are asking all families to respond to this survey no later than 7PM on July 29, 2021.

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* 1. Please choose one of the following statements.

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* 2. Student's legal first name

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* 3. Student's legal last name

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* 4. Student's date of birth

Date

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* 5. Student's ID Number

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* 6. Student's grade in 2021-22 will be:

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* 7. Parent/Guardian name

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* 8. Parent/Guardian email

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* 9. Parent/Guardian home phone

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100% of survey complete.

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