Parentcontactform

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CONTACT INFORMATION

Student Information:
Student’s First & Last Name: __________________________________________
Address: _________________________________________________________
_________________________________________________________
Phone Number: ____________________________________________________
E-Mail Address: ___________________________________________________

Parent/Guardian Information:
First & Last Name: _________________________________________________
Daytime Phone Number: _____________________________________________
Evening Phone Number: ______________________________________________
E-Mail Address: ___________________________________________________

First & Last Name: _________________________________________________


Daytime Phone Number: _____________________________________________
Evening Phone Number: ______________________________________________
E-Mail Address: ___________________________________________________

Does your child wear glasses? _________________________________________

What are your child’s strengths?


___________________________________________________________________
___________________________________________________________________

What are some areas where your child tends to struggle?


___________________________________________________________________
___________________________________________________________________

What motivates your child?


___________________________________________________________________
___________________________________________________________________

What are your goals for your child this year?


___________________________________________________________________
___________________________________________________________________

Please share any other information I should know about your child. Thank you!
___________________________________________________________________
___________________________________________________________________

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