• Parents / Caregivers: Please complete this form for your vaccinated student(s). We will use this information to calculate the vaccine rate for the school.

    Once 80% of eligible students are vaccinated, the district may apply for a waiver to lift the masking mandate at an individual school. The requirement will be lifted for vaccinated students and staff. When this happens, you will receive more information about the transition process.

    We request that you voluntarily share this information to assist in calculating the 80% rate referenced above. If you decline to provide this information for your eligible student(s), they will be considered to be not vaccinated, and will not count toward the 80% vaccination goal.


    Student Vaccination Attestation Form

DESE Policy on Vaccination Rate Threshold September 27, 2021

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