Maple Dale Elementary Student Information Sheet
School Year 2016-2017
The staff at Maple Dale Elementary makes every attempt to place all children in a classroom that meets their learning needs. This form is optional for parents and supplements the information given to us from your child’s teacher. You may fill out any or all parts of this form. Please return to the office in an envelope via “kid mail” by 4/8/16. In an effort to maintain balanced classrooms, requests for specific teachers are not considered. Thank you!
Child’s Name_______________________________________Phone:_____________________________
Current Grade_____________________________Current Teacher:_____________________________
Describe the ideal learning environment for your child:
List peer(s) with whom your child works well in a classroom setting:
1.________________________________ 4.______________________________________
2.________________________________ 5.______________________________________
3.________________________________ 6.______________________________________
(Every effort will be made to place your child with one of the six students listed above. If fewer than six
names are provided, the likelihood of your child being placed with the peers listed is decreased.)
Optional Comments:
