skip to main content
SES Student Input Form
Posted On:
Tuesday, July 09, 2019

SES Student Input Form 2019-2020


Name of Student: ___________________________                       Grade _______

Name of Parent Completing Form _______________________________


Administrators are in the process of configuring classes at SES for the 2019-2020 school year. Class placement is a very challenging process that takes into account meeting the needs of all students. The ultimate goal of this process is to create classes that promote high achievement for all students through a heterogeneous balance. Heterogeneous classes have a balance that reflects gender, ability and special needs. This balance allows for diversity within each classroom. Our staff will work very diligently toward this goal! If you would like to provide information about your child, please fill out this form. All information must be written on this form for it to be considered when placing your child in a class for 2019-2020 school year. This form can be picked up from the Stephens Elementary School main office Monday through Thursday from 7:30am – 4:00pm. It must be completed and returned no later than July 15, 2019.


Any special education, academic or counseling concerns? Yes ____   No ____            

If yes, what are they?



Please circle any of the following characteristics that best describe your child. (You may circle more than one)


Competitive                      Social                          Self-Directed                          Energy Level High

Quiet/Shy                          Dominate                    Overly Sensitive                      Energy Level Low

Friendly                             Submissive                  Matter of Fact                         Needs to be prompted

Resistant                           Indifferent                  Confident                                Disorganized

Self-conscious                   Reserved                     Anxious                                   Organized

Collaborative                     Peer-oriented               Easily Distracted                     Needs monitoring

Independent                      Out-going                    Enthusiastic                             Aloof




Is there any special health, personal, or behavioral concern you would like to share?




What do you see as the best type of learning environment for your child?




Are there any special circumstances you would like us to consider?




Any other comments you would like to add? (You may use the back if needed)




View all Spotlights