PARENT INPUT INTO THE PLACEMENT PROCESS
AT
IRWIN PARK ELEMENTARY SCHOOL FOR 2015/2016 SCHOOL YEAR
Child’s Name: _________________________________________________________
Current Grade and teacher for this 2014-2015 school year.
Grade this year:_____
Teacher this year:
___________________________
FOR NEXT SCHOOL YEAR
Please comment on, and rank in order, the following criteria, with 1. being the most important to you and 4.
being the least important.
RANK

ISSUE
Academic needs
COMMENT
_________________________________________________________
_________________________________________________________
____________________________________________________________________

Social/emotional
concerns that impact
learning.
_________________________________________________________
________________________________________________________
____________________________________________________________________

Learning environment
_________________________________________________________
_________________________________________________________
_____________________________________________________________________

Other
_________________________________________________________
_________________________________________________________
__________________________________________________________ _________
Name: _______________________________________
(Please print)
Phone No: ______________
This information will be given to the staff as one of the criteria to use and consider when deciding on your
child’s placement for the 2015-2016 school year.
* Note: Please DO NOT use any teacher names on this form. Forms that include teacher’s names will not be
considered in the placement process. No attachments please.
O:\Student placement forms