Please fill in all fields marked with an *

* What are the main concerns about this student:

Did the student receive learning support of resource teaching support in primary school? YesNo

If so, please give as much detail as possible (Subjects, number of years, number of classes weekly, duration of classes, size of classes):

Is the student receiving, or has this student received, learning support/ resource teaching hours in post-primary school:

YesNo

Learning Support:

Resource teaching support:

Please include the results of Standardised (Reading and mathematics) tests done in the last 2 years.

Please comment on the following:

* Is the student receiving any Speech and Language or Occupational Therapy interventions YesNo

If so, please give details:

Please give details of any in-school interventions being used with the child, commenting on the efficacy of these interventions etc..:

Any additional information or comments:

Consent

I/We understand that the results of this evaluation will be made known to me/us, to the School Principal, and, where the Principal deems it appropriate, to the relevant members of the school staff.

I consent to Edward Joyce Privacy Policy Terms, for more information click here.

Please enter the letters below and then click on the send button.