Student Placement Form
COMPLETE ONE FORM FOR EACH CHILD IN YOUR FAMILY ATTENDING DYER NEXT YEAR. NOTE: We do not honor specific teacher requests in the placement of children at Dyer.  
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Child's First Name *
Child's Last Name *
Parent's Name *
Primary Phone Number *
Your Child's Current Teacher *
Select current homeroom teacher from list
Your Child's Current Grade Level *
Select your child's current grade level
If your child is in any special program at Dyer, please check all that apply:
My child has academic STRENGTHS in the following subjects: (Check All That Apply)
My child has academic WEAKNESSES in the following subjects: (Check All That Apply)
Describe the ideal learning environment for your child:
If your child has medical concerns that should be considered, please list the concerns in the space below:
If you have additional information that should be considered, please include in the space below:
Please look over the form for accuracy before submitting. Complete one form for each child in your family attending Dyer next year. NOTE: We do not honor specific teacher requests in the placement of children at Dyer. Thank you!
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