Child's Name
*
First Name
Last Name
How long have you known the student?
What grade(s)/program(s) did you teach him/her?
Relationship with adults:
Relationship with peers:
Participation in Groups
Independence
Language and Communication Skills:
Transitions from one activity to another:
Classroom behavior:
Ability to handle conflicts:
Strengths and personality traits:
Areas in which child needs assistance:
Are there any concerns about the student's attendance or promptness in arrival or departure?
Does the family cooperate and communicate with classroom teachers, administration and respond to suggestions/guidance?
To your knowledge, is the parent’s perception of the child compatible with the school’s understanding of the child?
Is there participation and attendance in student and school wide activities and events (conferences, workshops, orientation, fundraisers)?
Additional comments:
Teacher's Name:
Teacher's Email: