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Parent 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_______________________________________

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

2.  What are your child’s strengths as a person and learner? ________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

3.  What do you perceive as your child’s social and academic needs? _________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

4.  How has your child felt about school in the past? ______________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

5.  Are there any personal issues that you would like me to know about or perhaps things that worry or upset your child? ____________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

6.  What are your child’s out-of-school interests? _________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Thanks so much!

 

Karen Caiati

 

The East Penn School District is an equal opportunity education institution and will not discriminate in its educational programs, activities or employment practices on the basis of race, color, national origin, sex, age, religion, ancestry, disability, union membership or other legally protected classification. Announcement of the policy is in accordance with state and federal laws, including Title VI, Title IX, Section 504 and Americans with Disabilities Act. Copyright 2009 East Penn School District.
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Last modified: 2012-04-12 01:34:07 PM (EDT)