2023-2024 Placement Input Form

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Dear Parents/Guardians:

We feel parental involvement is valuable when determining what is best for a child. Specific information from
you regarding academic and behavioral needs can assist us in placing your child. We cannot honor
requests for specific teachers or requests for students to be placed with specific peers.

This form is applicable for students currently enrolled in Wexford Kindergarten, 1st, and 2nd grade only. Current third-grade parents will receive a separate form sent from Eden Hall Upper Elementary.

Thank you for taking the time to complete the question at the end of this form. Your input will
be reviewed and considered during this process. Please do not reference specific teachers or specific peers. If you have more than one child, you will need to fill out this form separately for each child.

Please submit the completed input form no later than Friday, March 31, 2023, to ensure consideration
of your comments when making our decisions regarding placement. Thank you.

Mrs. Kelly Gustafson, Wexford Elementary Principal and Mrs. Brittany Papas, Wexford School Counselor

Please select the building that your child will attend for the 2023-2024 school year *

Wexford Elementary School

Last name of student *

First name of student *

Student ID number (number used to purchase lunch if known)

Current grade for 2022-2023 *

Kindergarten

Grade 1

Grade 2

Projected grade for 2023-2024 *

Grade 1

Grade 2

Grade 3

What special needs (academic, behavioral, or social) does your child have, or what particular concerns do you have about your child that you would like the school staff to consider when determining your child's placement in a classroom? Please do not reference specific teachers or students. We are unable to honor requests for specific teachers or requests for students to be placed with specific peers. Thank you. *

Full name of person completing this form *

Best phone number to contact person completing this form if clarification is needed. *

Best email address to contact person completing this form if clarification is needed. *

Please provide an electronic signature below by typing your full name to indicate that you are the person completing this form. If you are choosing to complete this optional form, remember to submit a separate form for each student. *

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