JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
California Healthy Kids Survey Parent Withdrawal: 9th/11th grade
Dear Placer Union High School District Parent or Guardian:
Please check the box below if you do NOT want your child to participate in the California Healthy Kids Survey.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
School:
*
Choose
Colfax High School
Confluence High School
Del Oro High School
Foresthill High School
Maidu Virtual Academy
Placer High School
Student Last Name
*
Your answer
Student First Name
*
Your answer
Parent Name
*
Your answer
Please select your choice:
*
No, I do not want my child to take the California Healthy Kids Survey
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Placer County Office of Education.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report