St. Joan of Arc School
230 South Law Street Aberdeen, Maryland, 21001
Grounded in Faith, Focused on the Future
Phone (410)272-1387 Fax (410)272-1959
[email protected]
HEARING SCREENING
Dear Parent/Guardian: On Thursday, October 26, Upper Chesapeake Health Systems will be in the school to conduct hearing screenings for all students in PreK, K, 1st, 4th and 8th grades, as well as all other new students. If you wish for your child to take part in the hearing screenings, please complete the bottom portion and return this form to school with your child(ren) by October 25. Each child should have his/her own permission slip and only those students with permission slips will be screened. We will need one or two parent volunteers to accompany students to and from the screening area. This is an opportunity to complete some of your service hours. Please remember that all volunteers must have completed child protection screening and training through the Archdiocese of Baltimore Shield the Vulnerable to help with all student events at St. Joan of Arc School.
_______________________________________ Child’s Name Date of Birth
_____________________________________ Parent/Guardian Signature
______________________________________ Parent/Guardian Phone Number
_____________________________________ Print Parent/Guardian Name
_________________________________ _____________________________ Home Address City, State, Zip Code
I want my child screened for hearing on October 26.
I do not want my child screened for hearing.
I can help with the screening on October 26.
___________ Grade
