Parent Teacher Conference Form

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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?
Student needs to:
Asks for help
8-10 hrs of sleep; alarm clock
 Attend school every day
Attends class every day
Attend After-School tutorials
 Be on time to class
Comes prepared with
Check homework log daily
 Bring all materials
materials
Clean up backpack/locker
 Remain seated during class
Comes to class on time
Daily Progress Report
 Complete class work
Completes homework
Enroll in an after-school program
 Participate appropriately
Does well on tests
Get health check-up & follow up
 Communicate respectfully
Gets along with other
Get phone #s of study buddies
 Help others as needed
students
Healthy breakfast & lunch daily
 Be positive towards
Has positive attitude
Obtain counseling: academic/
learning
Is respectful towards adults
social/emotional
 Pay attention, focus
Listens well
Obtain/meet with adult mentor
 Complete homework
Participates in class
Reward small improvements
 Other:
Solves problems
Student Attendance Review Team
________________________
Thinks creatively
Student Success Team
________________________
Other:
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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