Five Day Face-to-Face Instruction Survey
Complete this form to specify the method of instruction that you plan to allow your student to take part in as Sumter School District plans to transition to a five-day face-to-face instruction. Please complete this form for each student that attends Ebenezer Middle School.

Important point: After April 19th, hybrid instruction will no longer be an option. If you choose five-day face-to-face instruction and your student does not attend, they will be counted absent.
Student Last Name *
Student First Name *
Grade *
Parent/Guardian Last Name *
Parent/Guardian First Name *
Parent/Guardian Email Address *
Parent/Guardian Contact Number *
On April 19th, when Sumter School District returns to five-day face-to-face instruction, my child will: *
If my child attends the in-person model, he/she will commute to school as a: *
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