COVID-19 Screening Questionnaire
As COVID-19 continues to evolve, The Protestant Separate School Board of the Town of Penetanguishene and Burkevale Protestant Separate School sites are conducting active and daily screening on all outside visitors entering its facilities to ensure the safety and well-being of all.
The questionnaire must be acknowledged and submitted by any persons who desire access to either site before any use or access is permitted. If you are entering a site and are under the age of 18, the help of a Parent or Legal Guardian is required.
We are committed to protecting your privacy. The handling of all personal information by Government of Ontario organizations is governed by the Freedom of Information and Protection of Privacy Act.
Name (First and Last)?
Name of Parent/Guardian (if under the age of 18)?
Site Requested for Visit
Burkevale Protestant Separate School - 39 Burke Street, Penetanguishene ON, L9M 1C4
The Protestant Separate School Board of the Town of Penetanguishene - 2 Poyntz Street, Unit 48, Penetanguishene ON, L9M 1M2
Date Requested for Visit
Approximate Time Requested for Visit
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This form was created inside of Burkevale Protestant Separate School.