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* 1. What school does your child attend?

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* 2. Name of the teacher, who you would like to provide feedback for?

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* 3. Please rate your child’s teacher on a scale from 1-5 with 1 being low and 5 being high

  1 2 3 4 5
My child is learning in this classroom.
My child feels like they belong in this classroom.
My input is valued by this teacher.

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* 4. What are the strengths of your child’s teacher?

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* 5. What are the areas of improvement for your child’s teacher?

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* 6. Any other comments that you would like to add about this teacher

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