Request edit access
Employee In-Person Work Form
Pursuant to the Michigan Occupational Safety and Health Administration (MIOSHA) Emergency Rules, in-person work for employees is prohibited “to the extent that their work activities can feasibly be completed remotely.” If you are able to perform your duties remotely but plan to continue to work in-person at your building, please complete this form below:
* Required
Employee Name
*
Your answer
Job Title
*
Teacher
Paraprofessional/Learning Partner
Other:
Building
*
Kearsley High School
Armstrong Middle School
Fiedler Elementary
Dowdall Elementary
Weston Elementary
Days in which you plan to work in-person (please complete each week you plan to work)
*
Monday
Tuesday
Wednesday
Thursday
Friday
Required
Please select the reason you plan to work in-person
*
Issues with internet connectivity
Require classroom resources
Obtaining, printing, or making copies of classroom material
Other
Submit
Page 1 of 1
Never submit passwords through Google Forms.
This form was created inside of Kearsley Schools.
Report Abuse
Forms