Information is very important.
Class gender
Mode of back-to-school transportation
Contact information of student number
If you have any relevant information, please fill in □
/kloc-Is there any abnormality in health within 0/4 days?
No □
Yes □
/kloc-Is there any abnormality in the health status of family members within 0/4 days?
No □
Has the quarantine expired?
Yes □ No.
Has the quarantine expired?
what's up number
Yes □
Have you been to key areas and overseas for epidemic prevention and control during the holiday?
No □
Yes □
Did you come into contact with high-risk groups and overseas personnel in key areas of epidemic prevention and control during the festival?
No □;
I promise that the above information is true and accurate, and I am willing to bear the corresponding responsibilities if I conceal, misrepresent or omit it.
Commitment: Date:
Precautions:
1. The range of informants is all students in school.
2. If "No" is checked in the corresponding column of "Information Matters", there is no need to fill in "Details"; If "Yes" is checked, the specific information must be filled in truthfully, accurately and completely, and the specific date, time, personnel, place, activities, relevant measures taken and other details should be indicated, and filled in on different dates respectively.
This form must be filled out by the students themselves, and students should bring paper forms to the class teacher for reference when they report for duty.
Attachment 4 Yancheng Industrial Vocational and Technical College
202 1 notice of family responsibility for returning to school in spring semester
Name of student, name of parents
University, class
Contact number
Current address
Items to be filled in (tick the corresponding options or fill in specific information)
Su Kang code or community health declaration card status.
Overseas life history
Yes □ No.
Have the code red personnel been quarantined at the designated place 14 days? Have the yellow code personnel been isolated at home 14 days?
2. Students' current health status. Other information to be filled in (including whether the student has had contact with foreign salt workers in the past 14 days, whether the health of family members is abnormal and other information to be explained).
Red, yellow and green
1. Does the student have a history of living abroad in the past 14 days, the status of Sukang code or community health declaration card, isolation observation, etc.
Yes □ No.
Yes □ No.
Health, cough, fever, fatigue and other abnormal symptoms
It is everyone's responsibility to prevent and control the epidemic, and the safety of children is more important than Mount Tai. Parents are requested to fill in this notice truthfully at the beginning of school, and the students will give it to the class teacher when they return to school, and the school will keep it in a unified way. If there is any concealment or false information, the parents (guardians) shall bear corresponding legal responsibilities.
Yancheng industrial vocational and technical college
Date 202 1
Commitment letter for students to return to school.
I promise that the above information is true and accurate, and I am willing to bear corresponding legal responsibilities if it is untrue, concealed, misstated or omitted.
Signature of parents (guardians):