One-Day Virtual Workshops
Fall 2022

Public Speaking
Argumentative Writing
Leadership Conference

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Camp Health Screening Form

UNITED 4 SOCIAL CHANGE INC of 48 WALL STREET, NEW YORK, New York 10005 is monitoring the COVID-19 situation closely and following the directives of state and public health officials. To keep the health and safety of our community, you must fill out this declaration of health. This information will remain private and confidential unless it is necessary to contact trace any COVID-19 cases. Your information will not be used for any other purposes.

Fever
Breathelessness
Cough
Sore Throat
Loss of Smell
Loss of Taste
Vomitting
Diarrhea
Fatigue
Muscle Aches
Congestion or Runny Nose
Have you or any members of your household come into close contact with a confirmed case of COVID-19?
Have you or any members of your household traveled domestically to any hard hit areas in the United States?
Have you traveled internationally in the last 14 days?
Have you tested positive for COVID-19 within the last 30 days?