JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Grade 4 with Mrs. Kennelly at AVPS
Family Survey: Mrs. Kennelly
Welcome to the new school year! Please complete the following confidential form. The information in this form will help me keep in contact with you throughout the school year and will also allow me to get to know your child a little bit better.
**Please remember to press SUBMIT once the form is completed***
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Student's First Name:
*
Your answer
Student's Last Name:
*
Your answer
Student's Birthday:
*
MM
/
DD
/
YYYY
Guardian #1:
*
Please enter your first and last name.
Your answer
Relationship of Guardian #1 to Student:
*
Mother
Father
Step-Mother
Step-Father
Grandparent
Other:
Guardian #1 Daytime Telephone Number:
*
Your answer
Guardian #1 E-mail:
*
Your answer
Guardian #2:
Please enter your first and last name.
Your answer
Relationship of Guardian #2 to Student:
Mother
Father
Step-Mother
Step-Father
Grandparent
Other:
Clear selection
Guardian #2 Daytime Telephone Number:
Your answer
Guardian #2 E-mail:
Your answer
Primary Contact:
*
When information is shared regarding your child's strengths and next steps who should be contacted?
Guardian 1
Guardian 2
Both
Background Information:
*
Please tell me a little bit about your child. What do you see as his/her strengths? What does he/she need help with this school year? What extra-curriculars is he/she involved with? What are his/her hobbies/ passions? Is there anything else that you would like me to know about your child to help make this year successful?
Your answer
End of Day Dismissal:
*
How will your child be going home at the end of the day? Please share a bit about your child's end of day routines.
Your answer
Medical:
*
Does your child have any medical issues that I should be aware of to ensure his/her safety?
Your answer
Technology at Home:
*
Please provide me with a glimpse into what technology your child has access to at home (For example: a computer, tablet, printer, camera, headset).
Your answer
Photography:
*
Do you give consent for your child's photograph to appear on our class website and/or Google Classroom? (If you would like more information about this, please contact Mrs. Kennelly).
Yes
No
Best Year Yet:
*
As your child’s teacher, what do you think is the most important thing I should know about your child to be the best possible teacher for him/her?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Halton District School Board.
Report Abuse
Forms
