Team 5D Parent Contact Information (20/21)

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If both parents want to be contacted, please fill out this form separately for each parent or include both emails for question 4.

Email *

Please type in your child's last name: *

Please type in your child's first name: *

Please type in your full name. *

Which teacher is your child's homeroom teacher? *

Mrs. Galvin

Mrs. Elliott

Mrs. Meyer

Please type in your email: *

Please type in the best phone number to reach you. *

Child's birthday *

YYYY

Student lives with: *

Both parents

Mother

Father

Grandparents

Other:

Required

My child learns best by: *

listening

watching

doing

My child finds it challenging to... *

pay attention

follow directions

behave appropriately

speak in front of others

ask questions

Other:

Required

My child usually approaches learning ... *

with curiosity

With confidence

with excitment

with anxiety

with reluctance

without interest

Required

How would you describe your child's reading habits? My child... *

Enjoys reading alone.

Enjoys reading with others.

Reads well, but doesn't choose to.

has to be told to read.

Required

What are your child's strengths? *

In what areas would you like to see your child improve? *

What motivates your child? *

What kinds of things upset your child? *

Describe any medical/physical conditions or allergies your child has. *

For us to be able to teach your child the best, it is important that you share with us stressors in his/her life, past and present (death, divorce, parent living away, hospitalization, injury or illness (self or family member)). What can you share with us that will help us best meet the needs of your child? *

How would you rate your child's comfort with technology? (On a scale of 1-5 with 5 being completely comfortable and able to problem solve.) *

How would you rate your comfort with technology? (On a scale of 1-5 with 5 being completely comfortable and able to problem solve.) *

How independent/responsible is your child when it comes to online learning? *

Works completely independently with no help needed from adult at home.

Requires nudges and reminders from adult at home to join meetings and complete work.

Needs a lot of support with virtual learning from an adult at home.

Other:

Where have you designated your child's distraction free work space at home? *

What else do you think we should know about your child? *

What question or questions do you have that we can try to answer on our Curriculum Night on August 31st at 7:15-8:00? *

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