Student COVID-19 Self Certification Form for December – Due by December 1st
November 29, 2021

This is the December version of the self-certification form and needs to be filled out by a parent or guardian before December 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 December

Worthwoods Elementary Self-Certification Form for December

Worth Junior High Self-Certification Form for December