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Please complete this survey for each one of your students attending Ridgewood High School.

Parent/Guardian Name *

Student Name *

Grade Level *

Please check any boxes that apply for services received by your child. *

504

IEP

ELL

None

Other:

Required

Do you have younger children who attend elementary or middle school? *

Yes

If yes, what school(s)? (Fill out OTHER below)

Other:

Required

It is my hope that school opens ___________. *

Hybrid (Combination of Remote and In Person)

100% Remote Learning

100% in-person learning

Do you intend to send your student to school now that the Illinois Department of Public Health indicates that in-person instruction may resume? *

Yes

Why would you choose NOT to send your student back to school? Please select all that apply. *

I do not feel school is safe even with the Illinois Department of Public Health guidelines in place.

My student is/are at a higher risk for contracting COVID-19 due to chronic lung disease, asthma, a heart condition, immunocompromised, obesity, kidney disease, liver disease, diabetes, or other medical condition.

I have an immediate family member that is at higher risk for contracting COVID-19.

My student will have anxiety regarding returning to school in the midst of the COVID-19 pandemic.

I will wait until there is a proven vaccine for COVID-19 before sending my student(s) back to school.

Other:

Required

Based on my child’s personality, he or she does best: *

Having a regular, scheduled time to do classwork as established by the school or teacher.

Having the teacher set out the learning for the week and my child can work at his or her own pace. My child just needs to know the deadline and he or she can work toward that deadline.

Based on the online learning experience in the spring, my child completed school work during: *

Mark all that apply

the day (during normal school or business hours)

the afternoon or early evening

the evening

late into the night (past midnight)

the hours of midnight to morning

I don’t know

Required

Based on the online learning experience due to the stay-at-home order in the spring, my child: *

Did well with that format

Did not do well with that format

Based on the IDPH Requirements, all students and staff must wear a face mask ALL day. Will you still send your child to school knowing they must wear a mask ALL day? *

Yes

Is there anything else you would like to share with the school district as we plan for the fall?

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