Parent Input Survey 2019-2020
Please complete the following online survey so I can gather important information to start the school year.To save paper this year, most forms will be online; if you need a paper copy of anything please let me know I am happy to get that to you!
Student's First and Last name
Parent/Guardian #1 First and Last Name
Parent/Guardian #1 Phone Number
Parent/Guardian #1 Email
Parent/Guardian #2 First and Last Name
Parent/Guardian #2 Phone Number
Parent/Guardian #2 Email
What are some of your child's strengths and/or interests?
What is an expectation you have for this school year?
What is something that you and your family like to do for fun?
Please select any of the following that you might be interested in:
Art in Action
As part of the Common Core Curriculum, I use, Google Classroom, Google Drive and student gmail accounts through the DUSD account. Please confirm that you DO approve of the use of this account for your student
Yes, my child may use a district created Google account
No, my child may not use a district created Google account
Please review the 4th Grade Homework Policy (on a separate page on my teacher site) with your child.
We have reviewed the 4th Grade Homework Policy and understand it
Each new school year, all parent volunteers must be cleared through the office. Please indicate below that you acknowledge that you must be cleared to volunteer in our classroom, or chaperone on a field trip.
Yes, I understand that I must be cleared through the office before volunteering in the classroom or chaperoning on a field trip
As part of our Core Lit. experience, we try to compare/contrast the books we read to available movies. Some of these movies are rated PG. Please check the box if you DO NOT approve your child to see the movie.For more information, please visit
Island of the Blue Dolphins
The Adventures of Bullwhip Griffin
Thank you for taking the time to complete this survey. I'm looking forward to a wonderful year!
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This form was created inside of Dublin Unified School District.