Dear Parents,
Please print out, answer the questions, and return
this form to me. This information will be kept confidential.
Parent Name________________________________ Parent
e-mail_______________________________________
Student Name ____________________________
How does you child feel about school?
What subject does your child enjoy most?
In what areas does your child need special help?
Under what conditions does your child feel worried or
fearful?
How much time are you able to spend with your child
each evening to assist with homework and home reading?
How many hours a day does your child spend watching
television and playing video games?
What musical instrument does your child play?
What organized activity (dance, soccer, Pop Warner
Football/cheer, etc.) does your child participate in ?
How many minutes a day does your child read?
What are your child’s academic and personal
strengths?
Is there anything else you would like to share that
will help me understand your child better?