Essential Service Workers: Application for in-school support during Covid19

1. Please complete the following questions:

	Name
	Last Name
	Student(s) attending MCS

2. Which Essential Service Workers category do you fit into?

Tier 1: healthcare workers and emergency responders;
Tier 2: workers supporting vulnerable populations (e.g. social workers, income assistance workers); utilities workers and workers supporting key supply chain functions (e.g. grocery store workers, warehouse workers); and
Tier 3: teachers and childcare workers who do not have access to childcare and who are providing care or instruction to children of ESWs.

MCS is providing in-school support for child(ren) of Essential Service Workers if the family has no other access to at-home care for their children. If there is a spouse or family member, or the child is above the age of 12, we will not be providing this service as we wish to support our PHO's recommendations of self-isolation and social-distancing during this unprecedented and crucial time.

3. Is there a spouse or family member at home that does not have to leave the home for work purposes? *This question is required.

5. If you answered "yes" in question 3, please motivate your reason for applying for in-school care for your child. *This question is required.

If you are requesting child-care during 9am - 2pm, there will be a school support staff who will be supervising your child/ren of ESW personel in a designated classroom. This support staff will guide them through the curriculum.

5. Please provide information of an emergency contact person during this time.

Space Cell	Name	Last Name	Contact Number
Contact 1	Contact 1: Name	Contact 1: Last Name	Contact 1: Contact Number
Contact 2	Contact 2: Name	Contact 2: Last Name	Contact 2: Contact Number

Your application will be reviewed and you will be receiving a phone call for further discussion. Please note, school will not re-open until April 6th.

Essential Service Workers: Application for in-school support during Covid19

Family Information