October 3rd, 2020 -- SAT

at ICU High School Building (South Wing, 3rd floor only)

Questionnaire Concerning the Condition of the Examinee

* The SAT on October 3rd will be held at ICU High School and NOT at the University.

Specifically, ONLY the South Wing Building 3rd floor will be used.

There will be many posts guiding students to the building.

The only entrance will be from the Side Emergency Stairway on the Cafeteria side.

Upon entry, students will be required to have a temperature test.

If they have 37.5°Celsius or higher, they will not be allowed to test and they will have to go home.

Students will also be required to present their printed admission ticket.

Students have to bring their own mask and wear it for the entire test administration.

Throughout the day, wearing of a mask, frequent hand-washing, sanitizing, social distancing (always be 6 feet apart), ventilation, and prohibition of chatting are required to avoid infection.

* There is the highest risk when eating; therefore, students should eat and drink during breaks, if they must, while maintaining preventive measures.

* Please read the following questions, which will be found in the PDF document that can be downloaded.

Download the form, print it out, circle the appropriate responses, and show the form to the reception staff along with your printed admission ticket.

* If you do not answer True or Agree to all the five questions, you will be asked to leave and go home and you will not be able to test.

( Download the attached PDF file, print it, and fill the from to show at reception. The following is the TEXT format so that you can read it in this mail. )

Questionnaire Concerning the Condition of the Examinee

for October 3rd SAT at ICU High School

family / given /middle initial

Your name: _________________/___________________/_____________

Your registration number: ________________________

Your mobile phone number: ________________________

( for emergency contact, will not be used for any other purpose)

Your temperature in the morning of October 3rd: __________°Celsius

Your temperature measured at reception: __________°Celsius

(staff will fill this in)

* Circle the appropriate responses.

1. True Not True In the past 14 days, you have NOT come into close contact (withing 6 feet) with someone who has a positive covid-19 test or is presumed to have covid-19.

2. True Not True You do NOT have covid-19 or reason to believe you have covid-19. Symptoms of covid-19 include cough, fever, chills, muscle pain, shortness of breath or difficulty breathing, sore throat, new loss of taste or smell.

3. True Not True To your knowledge, you are NOT violating any travel restrictions or quarantining requirements.

4. Agree Not Agree You AGREE to wear a mask the entire time you are at this test site and follow instructions from testing staff.

5. Agree Not Agree We have taken measures to help create a safe testing environment; however, it is not possible to entirely remove the risk of covid-19 exposure. By entering the testing room, you AGREE to accept that risk.

Signature: __________________________________

Date: __________________________________