Mrs. Caiati 
17793 VisitsParent Input Form
Dear Parent(s):
In an effort to get to know you son or daughter, I am kindly asking you to fill this out. I really want to make a difference in his or her life this year, both emotionally and academically. I promise to read it carefully so that I may make decisions that are in the best interest of your child. Please return it to me at your earliest convenience, and I thank you very much for taking time to complete this!
Your Name: _______________________________________
Your Child’s Name: __________________________________
1. What is your greatest hope for your child as a 3rd grader_______________________________________
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2. What are your child’s strengths as a person and learner? ________________________________________
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3. What do you perceive as your child’s social and academic needs? _________________________________
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4. How has your child felt about school in the past? ______________________________________________
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5. Are there any personal issues that you would like me to know about or perhaps things that worry or upset your child? ____________________________________________________________________________
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6. What are your child’s out-of-school interests? _________________________________________________
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Thanks so much!
Karen Caiati
