2020-21 COVID-19 Supplemental Survey, June Report

NC Annual School Health Services Report Survey
2020-21 COVID-19 Supplemental Survey, June Report
Survey due no later than June 20, 2021

1. Person preparing the report (only one per school system, please) *This question is required.

First Name

Last Name

Job Title

Phone Number (###-###-#### work number):

Phone Number (###-###-#### summer contact): *This question is required.

Email Address (Make sure you enter this information correctly in the survey report. It will determine where your combined report is sent after completion) *This question is required. This question requires a valid email address.

2. LEA Information

LEA County *This question is required.

LEA Name and Number *This question is required.