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.
Email address *
Name (First and Last)? *
Name of Parent/Guardian (if under the age of 18)?
Phone Number *
Site Requested for Visit *
Date Requested for Visit *
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Approximate Time Requested for Visit *
Time
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