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COVID 19 Digital Learning Support Request
*
Indicates required field
Name
*
First
Last
Phone Number
*
Please include area code and phone number
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Are you a Henry County Resident?
*
Yes
No
Do you have a child or children at home who participate in Digital Learning for a Henry County School?
*
Yes
No
Select Yes or No
Proof of Henry County Residency (acceptable forms of proof of residency: copy of utility bill, mortgage statement, rental lease) Also provide proof of delinquency.
*
Upload File
*
Max file size: 20MB
Would you be willing to allow your child or children to go to the Jimmie Lee Smith Community in order to complete their Digital Learning?
*
Yes
No
*CDC COVID 19 Regulations are strictly followed. Every child will have their temperature checked upon entry, be required to wear a face mask/covering and be given hand sanitizer. Social distancing will be followed.
Which day(s) of the week would you allow your child to come to the Jimmie Lee Smith Community Center for Digital Learning?
*
Monday
Tuesday
Wednesday
Thursday
Friday
The Jimmie Lee Smith Community Center is located at 5883 Hwy 155 North Stockbridge, Georgia 30281. Do you have transportation to bring your child to the Jimmie Lee Smith Community Center?
*
Yes
No
Please type the name of the school which your child or children attend virually.
*
Does your child or children have their own laptop, tablet or other electronic device in order to complete digital learning?
*
Yes
No
Please advise if your child has been in contact with anyone in the last 14 days who has tested positive for COVID19.
*
Submit
Home
ABOUT US
Meet the staff
PROGRAMS
COVID19 Digital Learning Support
SPORTS
RUN & GUN CLASSIC
BASKETBALL ACADEMY
Get The Edge
MMBL
Pickleball
Summer Basketball Mini-Camp
Education
SUMMER CAMP
Virtual Learning
EVENTS
MEMBERSHIP
Community Activities
Events Calendar
Volunteers
Partnership
Silver Sneaker