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* 1. Your name.

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* 2. The names and grades of each of your children who attend SBRSD.

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* 3. Does your child fall into one or more of the high risk categories for severe illness as defined by the CDC ?

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* 4. Does anyone living with your child fall into one or more of the high risk categories for severe illness as defined by the CDC?

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* 5. Do you feel it is safe to return to schools in person in the fall?

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* 6. Fully On-Site – all students returning to the buildings full-time with health precautions in place, desks spaced 3 feet apart and use of all spaces within the building for “classrooms” (this may include the library, gymnasium, or hallways).

Are you comfortable returning to school following the Fully On-site model?

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* 7. Hybrid – students alternating between in-person learning and remote learning with desks 6 feet apart and following social distancing guidelines. Simultaneously a fully remote learning option will also be in place. Families, who choose to remain fully remote, will be able to opt into the on-site model at any point. There may also be a fully on-site assignment for students with high needs as defined by DESE.

Are you comfortable returning to school following the Hybrid model?

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* 8. Remote – all students learning remotely following structured learning time requirements. This is a more rigorous approach than remote learning was in the spring. It will include a traditional attendance, grading, and credit-based system. Students with high needs as defined by DESE may be assigned on-site learning for all or part of each week.

Are you comfortable returning to school following the Remote model?

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* 9. Will your children return to on-site learning at school in the fall?

Please note any differences in your plans for each child by selecting "Other" and describing.

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* 10. Would you prefer to start the year with Remote Learning, Hybrid, or Fully On-Site learning?

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* 11. If on-site learning is available, do you plan on using the buses for transportation to and from school for your child(ren)? Please identify any differences among multiple children by selecting "Other" and describing. 

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* 12. Please share any additional comments or concerns you may have.

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