2019 Student Placement Survey
Please use this form to provide additional information about your student's academic and social learning needs. While we cannot accept specific teacher or classmate requests, we want to give you the opportunity to share specifics about your student's needs which will help in our decision making process.
Please note: only Kindergarten, 4th grade and 5th grade have multiple sections and teacher options for the 2019-20 school year, however this information is still valuable for a teacher to know, even if there are no options for teacher assignment.
Please complete by August 1, 2019.
Student's Legal Name *
Your answer
Name of Person Completing Form *
Your answer
2019-20 Grade Level *
Academic Considerations-- strengths and needs
Your answer
Emotional/Behavioral Considerations-- strengths and needs
Your answer
Social/ Peer Relationship Considerations (i.e. a student who should NOT be assigned to the same classroom as your child because of prior conflicts). Please explain.
Your answer
Physical/Health Considerations (hearing, vision, health, etc.)
Your answer
Other comments of significance that may affect your child's success at school.
Your answer
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