Sample Parent / Teacher Conference Form



Parent / Teacher Conference Form

Note: Parent/Teacher conferences may be used as an intervention prior to referral to the SAP or recommended as part of a SAP action plan. This sample form offers a guide through a documented conference discussion.

School Name: _______________________________________ Date: ________________

Student: ____________________________________________ Grade: ________________

Parent/Caregiver: ____________________________________ Language: _____________

Parent Contact Information (telephone #): _____________________________________________

Teacher(s) participating in conference (name and subject taught):

1) ________________________________________________________________________________

2) _______________________________________________________________________________

3) _______________________________________________________________________________

|Strengths? |Concerns? |Ideas for parent/student? |

|Asks for help |Student needs to: |8-10 hrs of sleep; alarm clock |

|Attends class every day |Attend school every day |Attend After-School tutorials |

|Comes prepared with materials |Be on time to class |Check homework log daily |

|Comes to class on time |Bring all materials |Clean up backpack/locker |

|Completes homework |Remain seated during class |Daily Progress Report |

|Does well on tests |Complete class work |Enroll in an after-school program |

|Gets along with other students |Participate appropriately |Get health check-up & follow up |

|Has positive attitude |Communicate respectfully |Get phone #s of study buddies |

|Is respectful towards adults |Help others as needed |Healthy breakfast & lunch daily |

|Listens well |Be positive towards learning |Obtain counseling: academic/ social/emotional |

|Participates in class |Pay attention, focus |Obtain/meet with adult mentor |

|Solves problems |Complete homework |Reward small improvements |

|Thinks creatively |Other: ________________________ |Student Attendance Review Team |

|Other: |________________________ |Student Success Team |

|_____________________ |________________________ |Weekly Progress Report |

| | |Other: |

| | |_______________________________ |

Comments/Notes

______________________________________________________________________________________________________________________________________________________

Signatures

Parent/Caregiver: _______________________________ Teacher(s): ___________________________________

Student: _______________________________________ Date: _______________________________________

SFUSD Student Support Services Department – SAP Manual August 2009

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