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Get Maltby Parent Input Form for Classroom Environment 2004-2024

Parent Input Form for Classroom Environment Maltby Elementary School Due Date Friday April 28 please return to the school office. Student Name Current Grade Parent Name Current Teacher 1. Describe the environment in which your child learns best 2. Other information including health issues or needs to consider in your child s placement 3. My child is currently receiving help in a b c d e f Reading Math Spelling Writing Speech Social skills interpersonal skills 4. Without being asked my child reads at home a Often b Seldom c Never 5. In a large group my child Is able to focus attention without difficulty Needs occasional monitoring to focus on task Has difficulty remaining on task Is easily distracted 6. My child a Makes friends easily b Is uncomfortable in new social situations c Avoids new social situations 7. My child s strongest area is a Reading and Language Arts c Science d Social Studies e Other 8. My child s weakest area is 9. If the opportunity were to arise I would like my child to experience a A single grade classroom b A Multi-age classroom c No preference 10. Student Name Current Grade Parent Name Current Teacher 1. Describe the environment in which your child learns best 2. Other information including health issues or needs to consider in your child s placement 3. My child is currently receiving help in a b c d e f Reading Math Spelling Writing Speech Social skills interpersonal skills 4. Other information including health issues or needs to consider in your child s placement 3. My child is currently receiving help in a b c d e f Reading Math Spelling Writing Speech Social skills interpersonal skills 4. Without being asked my child reads at home a Often b Seldom c Never 5. In a large group my child Is able to focus attention without difficulty Needs occasional monitoring to focus on task Has difficulty remaining on task Is easily distracted 6. Without being asked my child reads at home a Often b Seldom c Never 5. In a large group my child Is able to focus attention without difficulty Needs occasional monitoring to focus on task Has difficulty remaining on task Is easily distracted 6. My child a Makes friends easily b Is uncomfortable in new social situations c Avoids new social situations 7. My child a Makes friends easily b Is uncomfortable in new social situations c Avoids new social situations 7. My child s strongest area is a Reading and Language Arts c Science d Social Studies e Other 8. My child s weakest area is 9. My child s strongest area is a Reading and Language Arts c Science d Social Studies e Other 8. My child s weakest area is 9. If the opportunity were to arise I would like my child to experience a A single grade classroom b A Multi-age classroom c No preference 10. Student Name Current Grade Parent Name Current Teacher 1. Describe the environment in which your child learns best 2. Other information including health issues or needs to consider in your child s placement 3. My child is currently receiving help in a b c d e f Reading Math Spelling Writing Speech Social skills interpersonal skills 4. Without being asked my child reads at home a Often b Seldom c Never 5. In a large group my child Is able to focus attention without difficulty Needs occasional monitoring to focus on task Has difficulty remaining on task Is easily distracted 6. .

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