WESTBROOK ELEMENTARY SCHOOL
Family Information Checklist for School Year 2016-2017
Dear Westbrook Families:
The following information will be used to help the Westbrook staff identify an appropriate class
placement for your child. If your child will be a student at Westbrook next year please return
this to your child’s teacher or the school office by Friday, April 22, 2016.
PLEASE USE PEN
This is your opportunity to describe your child as a learner 
Child’s Name: __________________
Next Year’s Grade Level (circle one)
Current Teacher _____________
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While teachers are aware of each student’s strengths and needs, a parent is often able to
provide additional information that can be used in class placement. Please indicate only those
areas that are special strengths or particular areas of need for your child. Note: We do not
honor individual teacher requests.
Strengths
Areas of Need
If you would like to share any additional information, please feel free to attach or include
comments on the back of this form.