Grade 5.3 & 5.4 Parent/Guardian Feedback Form
Dear parents and guardians,
Please feel assured that all information provided here will be treated as confidential and will only be used by staff in the best interests of your child. There are a few optional questions, so please ensure that all required questions are answered prior to submitting the form. Thank you for your time.
Best,
The Grade 5 team
Email address *
Student's LAST Name *
Your answer
Student's FIRST Name *
Your answer
Parents'/Guardians' Names *
Your answer
How does your child feel about school? *
Your answer
List your child's special interests (sports, church/community groups, books, music, etc.) *
Your answer
List all languages spoken at home with your child. *
Your answer
Please list your child's strengths as a learner. *
Your answer
Please list your child's areas for growth (weaknesses) as a learner. *
Your answer
What is the most important area of growth you would like for your child this year (reading, getting along with others, self-confidence, etc.)? *
Your answer
How would you describe your child's social interactions? *
Your answer
Please tell us any other information that we may need to know about your child that you have not already mentioned.
Your answer
It would be helpful if you would inform the teacher to situations that may affect your child during the school year (new baby, death, separation, divorce, hospitalization). Any information will be treated confidentially.
Your answer
Has your child had any significant (your opinion is that one that counts!) experience (hospitalization, accidental poisoning, head injury, fracture, death in the family, etc.) which you would like your son or daughter's teachers to be aware of so that they can be sensitive to that topic?
Your answer
Other comments
Your answer
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