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LEADERSHIP - PARENT CHECKLIST QUESTIONNAIRE
Please complete the following inventory/questionnaire about your child. This information will help us provide students with opportunities to develop strengths in learning.
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Student's Name
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School
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Hopkins Elementary School
Meece Middle School
Somerset High School
Grade
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4
5
6
7
8
9
10
11
12
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YYYY
Name of Parent/Guardian completing this form:
Your answer
What are your child's strengths?
Your answer
What type of things or situations see to frustrate your child?
Your answer
What things might be helpful to know about your child that may not be easily seen at school?
Your answer
Are there any academic/social/career concerns you have about your child? Please elaborate.
Your answer
Is there anything else you would like for us to know about your child?
Your answer
Please check the characteristics that accurately describe the TYPICAL behavior of your child.
Sought by others when something must be decided to make things happen.
Tends to dominate peers and direct activities.
Initiates activities that involve peers (positive or negative) and communicates enthusiasm for tasks to others.
Judges abilities of others and finds a place for them.
Interacts easily and cooperates with both children and adults.
Sought out by peers for play/activities and is often captain/leader of the team/group.
Has a sense of justice and fair play; is sensitive to the feelings of others or to situations.
Carries responsibilities well, can be counted on to do what he/she promised.
Is self-confident, able to enter a group of students and be easily accepted.
Adapts easily; is flexible.
Please list any awards/recognitions your child has received which relate to creativity.
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