Student COVID-19 Self Certification Form for October – Due by October 1st
September 28, 2021

This is the October version of the self-certification form and needs to be filled out by a parent or guardian before October 1st.  Instead of the daily form that was used last year, we are filling out these forms monthly throughout the school year.  A form needs to be filled out for each student, and please make sure to select the form for the correct school.

Worth Elementary Self-Certification Form for October

Worthwoods Elementary Self-Certification Form for October

Worth Junior High Self-Certification Form for October