Shelton Travel Survey
If you have traveled aboard or out of state during the holiday break or any other times, we ask you to please share some basic information with us so that we have the background knowledge we need to keep our students and staff healthy and safe.

The locations that meet the criteria are included in Connecticut's travel advisory in the link below:

https://portal.ct.gov/coronavirus/travel

Thank you for your cooperation.
Email address *
Name (first and last) *
I am *
School/Location *
Location traveled *
Mode of travel: *
Departure Date: *
MM
/
DD
/
YYYY
Return Date: *
MM
/
DD
/
YYYY
If travelled, are you quarantining for 10 days ?
Clear selection
If you chose to not quarantine, did you test out?
Clear selection
If you have tested out, please forward your negative test result to your school nurse.
Anyone who is suspected of a violation of quarantining will be reported to DPH.
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