Teacher Exclusion Form
*Must be turned in by May 1*

We will make every attempt to provide your child with the most effective learning experience.
Email *
Child's Name: *
Parents Name: *
1. List of your child’s strengths.
2. List of any academic concerns you have for your child (be specific as possible).
3. Please explain what style of teaching/classroom environment works best for your child.
4. Are there concerns with your child being with another child and reason why?
5. Any additional information that you can provide in helping to make classroom assignments?
Teacher Exclusion:
Unfortunately, sometimes there are reasons that we must exclude a child from a teacher’s classroom as we feel it will not be the best learning environment for him/her. Some of the reasons that may prevent a child from learning in a teacher’s classroom might include being closely related to the teacher, family disagreements with the teacher, court matters with the teacher to just list a few. If there is a teacher you need to exclude your child from having next school year, complete the following in its entirety.
Teacher Excluded: Reasons for Exclusion (Be specific as possible for our understanding and to ensure your child is placed in the best learning environment for him/her).
We will make every effort to ensure your child is provided with the greatest learning experience.
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