Sixth Grade Supply List



Child’s Name (Name your child prefers to be called): ____________________________________Parents’/Guardians’ Names and Phone Numbers:Home - Work - Cell – Who does the student live with? (Circle all that apply)Mother Father Stepmother Stepfather GrandmotherGrandfather Aunt Foster ParentWould you like to share any information regarding religious background and/or holidays celebrated (or not celebrated)? _________________________________________________________Is your child supposed to be wearing glasses? ____________ E-mail address (please print below):*This is the most convenient way for us to communicate with you. Please provide an email address(es) that you check regularly. ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Does your child have access to the internet and printer at home? _______________________542353528575List three of your child’s strengths: 1.2.3.My child is interested in (academically) ________________________________________________________________________________________________________________________________________________________________________________My child is interested in (outside of school) ________________________________________________________________________________________________________________________________________________________________________________What causes anxiety for your child in regards to school/friends, etc.?________________________________________________________________________________________________________________________________________________________________________________What is one area in which your child needs improvement? ________________________________________________________________________________________________________________________________________________________________________________Academically this year, I would like to see my child ________________________________________________________________________________________________________________________________________________________________________________What are some ways we can work together to make this a successful year for your child? ________________________________________________________________________________________________________________________________________________________________________________Socially this year, I would like to see my child ________________________________________________________________________________________________________________________________________________________________________________Something I would like to share with you about my child is ________________________________________________________________________________________________________________________________________________________________________________Are there any situations at home that may influence learning (loss of pet, divorce, death of family member or friend, new baby in the family, etc.)? ________________________________________________________________________________________________________________________________________________________________________________Parent/Guardian Signatures (anyone who may be signing student papers) ________________________________________________________________________________________________________________________________________________________________________________Thank you for taking the time to fill out this survey! Please have your child bring this to school on Monday, August 18th. Surveys are due by Friday, August 22nd. ................
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