JICS Masking Program Registration

In this survey, we are interested in understanding how many families are supportive of and committed to a laundered mask program at JICS, starting January 2021.

Based on the level of commitment (a minimum of 100 participants), we will proceed.

Please note that the information you provide in this survey will be shared with the providers and fellow parents, Lisa Strug and Andrew Murray.

Payment via eTransfer will be requested once we have confirmation that the program will proceed.

Question Title

* 1. Which Masking Program option are you most interested in?

Option 1 - Masks + Laundry Service ($3.50/day) - Grade 6 is sized "Youth", all others are sized "Kids"

Option 2 - Masks for Purchase only ($36 for a set of 3) - Please indicate size in following questions

Question Title

* 2. Contact Information

Name of Parent(s)

Email Address

Phone Number

Question Title

* 3. Child 1 Information

Name of Child

Grade

Option 2 - # of Masks (in multiples of 3)

Option 2 - Mask Size (Kids, Youth, Large, Extra Large)

Option 2 - Mask Colour (Blue, Black)

Question Title

* 4. Child 2 Information

Name of Child

Grade

Option 2 - # of Masks (in multiples of 3)

Option 2 - Mask Size (Kids, Youth, Large, Extra Large)

Option 2 - Mask Colour (Blue, Black)

Question Title

* 5. Child 3 Information

Name of Child

Grade

Option 2 - # of Masks (in multiples of 3)

Option 2 - Mask Size (Kids, Youth, Large, Extra Large)

Option 2 - Mask Colour (Blue, Black)