Mālama 21st Program Enrollment Form

Mālama 21st Program Enrollment Formwebmaster2021-02-15T16:11:59-10:00

Hooray, youʻve been accepted. Hereʻs the form to provide all the student details for enrollment.

Before coming to activities, each student/participant must perform a daily symptom screening. Please help us keep everyone safe and healthy.

In your household:

Has anyone tested positive for COVID-19?
Is anyone on home isolation?
In the past 5 days, has anyone had any of the following symptoms that are new or worsening, and not attributable to an unrelated pre-existing condition?

- - - - Fever greater than 100.4 °F or feeling feverish (chills, sweating)
      - Cough
      - Shortness of breath/difficulty breathing
      - Sore throat
      - Unexplained muscle/body aches
      - Nausea/vomiting or diarrhea
      - Loss of senses of taste or smell
      - Unusually weak or fatigued
      - Runny or congested nose
      - Headache
      - Skin rash
      - Chest pain or pressure

In the past 14 days:

Has the Department of Health told you or a member of your family that they have been in contact with a person with COVID-19?
Has someone who lives with you or works closely with you been told by the Department of Health to stay home?
Has anyone participated in a group gathering of more than 14 people?
Has the student/participant traveled out of the state and, as a result, currently under quarantine orders by the Department of Health or your medical care provider?

Has the student/participant been in close contact (less than 6 feet apart for more than 15 minutes) with anyone that has been diagnosed with COVID-19?

If you have answered YES to any of the above,

please contact PAF and do not come to face to face activities.

Before coming to Pacific American Foundation (PAF) in-person activities, please help us by following the recommended guidelines:

Shower and wash body immediately prior to departure for PAF in person activities.
While in transit to activities, please maintain physical distancing and utilize proper PPE including a face mask.

When you arrive:

Please wear your face mask.
Stay in your vehicle until we check your temperature. If you are in the normal temperature range (97°F (36.1°C) to 99°F (37.2°C) you are welcome to participate. If you have a fever, you will be dismissed and advised to seek health care.

During activities, we take steps to keep students/participants safe, and ask you to assist us:

Learning tools given out to specific individuals may not be shared amongst students/participants.
Learning tools will be cleaned and sanitized by the individual who is handling it, under direction of staff to ensure proper cleaning and storage.
All participants/students shall continue to wear masks and physically distance at least 6 feet when practical. When distancing is not practical and cannot be maintained, after a period of 10 minutes, children will pause work and step away from each other for 3 minutes before returning to the activity.
Student work, when complete, can be photographed and emailed to the field lead instructor.

At the end of the day:

Learning tools will be stored, gloves will be removed, and hands will be sanitized.

When the student/participant returns home, it is recommended that they immediately shower, washing their hair and body, and that their clothing worn during the day is laundered.