COVID NOTIFICATION FORM
If you have produced a Positive result from a Covid-19 PCR or RAT test please fill in below. This information will help us determine what next steps need to be taken.
Student Name
*
First Name
Last Name
Year group at school
*
Y1
Y2
Y3
Y4
Y5
Y6
Y7
Y8
Y9
Y10
Y11
Y12
Y13
Room number / Form class / Kgroup
*
Date of Birth
*
Date last attended school
*
-
Day
-
Month
Year
Date
Type of Test
*
PCR
RAT
Date of Test
*
-
Day
-
Month
Year
Date
Date Result Received
*
-
Day
-
Month
Year
Date
Please upload a screenshot of the test result
Browse Files
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of
Please give names of any siblings that this student has at Bethlehem College - if you have any other BC students living with you please include here also
Name of Parent completing this form
*
Submit
Should be Empty: