Sample Parent / Teacher Conference Form

Parent / Teacher Conference Form

Note: Parent/Teacher conferences may be used as an intervention prior to referral to the RTI or recommended as part of a PBIS action plan. This form offers a guide through a documented conference discussion. D.M. Smith Middle School 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  Be on time to class  Check homework log daily materials  Bring all materials  Clean up backpack/locker  Comes to class on time  Remain seated during class  Daily Progress Report  Completes homework  Complete class work  Enroll in an after-school program  Does well on tests  Participate appropriately  Get health check-up & follow up  Gets along with other  Communicate respectfully  Get phone #s of study buddies  Help others as needed students  Healthy breakfast & lunch daily  Be positive towards learning  Has positive attitude  Obtain counseling: academic/  Pay attention, focus  Is respectful towards adults social/emotional  Complete homework  Listens well Obtain/meet with adult mentor  Other:  Participates in class  ______ Reward small improvements  Solves problems ______ Student Attendance Review (secretary)  Thinks creatively ______ Student Success Review  Other:  Weekly Progress Report ______ Other: ______

Comments/Notes ______

Signatures

Parent/Caregiver: ______Teacher(s): ______

Student: ______Date: ______

PBIS – Positive Behavioral Interventions & Supports {D.M. SMITH MIDDLE SCHOOL} 2014 Parent Observation Form

Welcome! We are happy you are able to visit us today and hope your visit is an enjoyable one. Please plan to observe for a period of 25 to 30 minutes. You will find the experience informative and interesting. You might want to jot down comments and questions during your observation to share with a staff member after class. FACT: If you have a child in the class, please keep in mind the fact that your own child will be excited by your presence. He may try to perform for you, he may become shy, he may not be able to tear himself away from your side. In any case, his behavior in the class will probably be somewhat different that usual. For this and many other reasons, it is unwise to try to compare your child with the others.

D.M. Smith Middle School Date: ______

Student: ______Grade: ______

Parent/Caregiver: ______Language: ______

Parent Contact Information (telephone #): ______

Teacher(s) participating in observation (name and subject taught): 1) ______2) ______3) ______4) ______5) ______6) ______7) ______8) ______

Observational Concerns? (In your student)  Please sit quietly!  Please keep interaction with the teacher to a minimum unless approached.  Observe the entire classroom!  Look for qualities of:  Independence  Self-discipline  Social interaction  Attention concentration  Class Enjoyment (Joy) (In the teacher)  Awareness class dynamics (Objectives posted, Bulletin boards, Desk/Table Arrangement, etc.)  Sensitivity to individual children  Helps children initiate work  Demonstrates use of materials/technology through lessons  Other:______

Comments/Notes ______Signatures Parent/Caregiver: ______Teacher(s): ______

Student: ______Date: ______

PBIS – Positive Behavioral Interventions & Supports {D.M. SMITH MIDDLE SCHOOL} 2014