ES Self declaration document 2020

Page 1

Covid-19 self-declaration

Please complete the form and upload it under the documents section of your profile on EF Campus Connect (my.ef.com), or send it to your local EF office before arrival at your host family/residence/campus. I, the undersigned, (Mr./Ms) ________________________________________________________________________ Address _________________________________________________________________________________________ Daytime telephone ________________________________________________________________________________ Acting as parent/guardian of: _______________________________________________________________________ I am taking a language course at EF in _____________, from _________________ until________________________ I declare that: 1) I currently do not have symptoms of, or have not been diagnosed with, the coronavirus disease (COVID-19). 2) In the past 14 days, I have not been in contact with someone who is infected with the Coronavirus. 3) I do not have a persistent cough, difficulty breathing, cold, sore throat, headache, severe weakness (tiredness), decrease or loss of smell/taste, diarrhea or a fever above 37.5 C. EF International Language Campuses requires all of its students to arrive at the host family/residence/ school with a negative Sars-CoV-2 (Covid-19) PCR test (swab test) that is no older than 72 hours. I was tested within 72 hours prior to arrival and my Covid-19 test is negative. I have tested within 72 hours prior to arrival, but do not have the result yet. I will be quarantined until I get the test result proving that I am negative. I have not tested before arrival. I will test at destination and will be quarantined until I get the test results proving that I am negative.

_____________________________________________ Date and place

_____________________________________________ Signature of student/legal guardian for minors

I N T E R N AT I O N A L L A N G U AG E CAMPUSES

For all students attending an EF International Language Campus

www.ef.com


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