Help Me Get to Know Your Student
Student Name
*
First Name
Last Name
Nickname or Preferred Name for Student
Preferred Guardian Contact Name
*
First Name
Last Name
Preferred Guardian Contact Phone Number
*
-
Area Code
Phone Number
Preferred Guardian Contact E-mail
*
example@example.com
What is your preferred contact method?
*
Phone Call
E-mail
Text Message
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If your student attended school at Rainier Elementary last year, who was their teacher?
Teacher Name
Who does your student reside with?
*
Both Parents
Father
Mother
Guardian
Other
Are there any holidays and/or special occasions that your student is unable to participate in? If yes, please explain below.
Does your student have any formal accommodations, plans, or receive any special services? Check all that apply.
504
IEP
ELL
Reading Intervention
Math Intervention
None
Other
If your student currently has a 504 or IEP, please BRIEFLY explain what the plan is for:
Please indicate the level of support or help you feel that your student needs in each of the following areas:
*
Rows
A lot of Support
Some Support
Limited Support
No extra support/
Student excels in this area
Handwriting
1
2
3
4
Writing Skills
5
6
7
8
Math
9
10
11
12
Reading
13
14
15
16
Following Directions
17
18
19
20
Organization
21
22
23
24
Self-Advocating
25
26
27
28
Making Friends
29
30
31
32
Please elaborate on any of the above areas if needed:
Will your student be sharing a device with siblings or family members that currently need it for work/school?
*
Yes
No
In the Fall, the district will likely distribute packets similar to the Spring. Our class will be supplementing, or changing the given materials to best suit the needs of our students. This means that parents will have to access the class packets from a source OTHER than the school bus route. Please indicate the ways in which you would be able to retrieve work for your student on a weekly basis.
*
Drop Box in front of the school
Print at home (weekly work may be 10-20 pages in length)
None of the above. I would need either a digital format assignment (type in answers) or receive the packet in an alternative way.
Are there any specific family scheduling concerns that I need to know about prior to creating your student's online schedule? (Note: I will do my best to accommodate when possible, however, there is no guarantee that I can meet all parents' requests. I am unable to offer night or evening sessions for students.)
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What are some of your student's personal interests? (dinosaurs, mermaids, playing football, etc.)
*
Do you have any academic or behavioral concerns for your student?
*
How does your student typically feel about school?
*
Is there anything else you think I should know?
Submit
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