Optional Parent Input Form 2020-2021

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While our staff works diligently to create balanced classrooms, we understand you may have concerns for your child while he/she is here at school that you would like us to consider. If needed, please complete any of the following questions you feel would provide us with pertinent information. We will not look back at old forms for information, so please update every year. All information is confidential among school staff.

Please complete this form by June 5th.

Specific requests for placement will not be honored.

Email *

Student First and Last Name *

Rising Grade Level 2020-2021 *

2019-2020 Teacher's Name *

Please list any teachers currently at Rea View that have tutored your child:

Please separate my child from:

I would describe my child as (please check all that apply): *

overly concerned with pleasing adults

has difficulty paying attention

easy going

strong willed

a leader among his/her peers

mature for his/her age

quiet (can go unnoticed)

Other:

Required

My child needs / thrives in

a more flexible classroom setting

a more structured classroom setting

Other:

Clear selection

Please describe any academic concerns:

Please describe any social concerns:

The past school year my child has benefited from the following:

The past school year my child did NOT benefit from the following:

Please consider the following transitions our family will have over the summer/during the school year:

Please consider the following medical condition when making class placement for my child:

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