COVID-19 Staff Travel Report Form
Use this form to report student and parent travel to level 3 designated countries - Currently: China, Iran, Italy and South Korea (This list is subject to change)
Email address *
First and last name: *
Best contact number: *
Which Level 3-1 country did you visit? *
If "other" was selected, which country was visited?
Date that you returned from level 3 designated country: *
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DD
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YYYY
Date that you may return to school and is symptom-free (must be no less than 14 days from return date to US): *
MM
/
DD
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YYYY
Work location: *
A copy of your responses will be emailed to the address you provided.
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