Covid Test Results Submission Form
Please fill out this form once for each student or educator who will be returning to campus on or after February 22, 2021.
First and last name of person whose test results are being submitted.
*
First Name
Last Name
Student ID Number
Full name of parent submitting test results (if applicable)
First Name
Last Name
Phone Number of adult submitting test results
*
Please enter a valid phone number.
Email Address of adult submitting test results.
*
example@example.com
Date Test was taken.
*
-
Month
-
Day
Year
Date
Please select the appropriate designation for the person whose test results are being submitted.
*
Grade 9
Grade 10
Grade 11
Grade 12
Educator
Parent Volunteer
Which on campus cohort is the student assigned to?
*
Green
Gold
Upload Test Results
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A scanned PDF, JPEG/image file, or screenshot of test results.
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