Sample Complete School Retention Form

Derrick Meador, M.Ed., is the superintendent for Jennings Public Schools in Oklahoma. He previously served as a school principal and middle school science teacher.

Student retention is always highly debated. There are clear-cut pros and cons that teachers and parents must take into consideration when making such an important decision. Teachers and parents should work together to come up with a consensus as to whether or not retention is the right decision for a particular student. Retention will not work for every student. You must have strong parental support and an individualized academic plan that promotes an alternative to how that student is taught, as compared to previous years.

Each retention decision should be made on an individual basis. No two students are alike, thus retention must be examined. Take into account the strengths and weaknesses of each individual student. Teachers and parents must examine a wide array of factors before deciding whether or not retention is the right decision. Once a retention decision has been made, the next step is to explore how the student's individual needs are going to be met at a deeper level than before.

If the decision is made to retain, it is important that you adhere to all guidelines laid out in the district's retention policy. If you have a retention policy, it is equally important that you have a retention form that gives a brief description of the reasons the teacher believes the student should be retained. The form should also provide a place for parents to sign and then either agree or disagree with the teacher's placement decision. The retention form should summarize placement concerns. However, teachers are strongly encouraged to add additional documentation to support their decision, including work samples, test scores, teacher notes, and so on.

Sample Retention Form

The primary goal of (school name) is to educate and prepare our students for a brighter tomorrow. We know that each child develops physically, mentally, emotionally, and socially at an individual rate. Additionally, not all children will complete 12 grade levels of work according to the same pace and at the same time.

Grade level placement will be based on the child’s maturity (emotional, social, mental, and physical), chronological age, school attendance, effort, and marks achieved. Standardized testing results can be used as one means of the judging process. The grade marks earned, direct observations made by the teacher, and academic progress made by the student throughout the year shall reflect the probable assignment for the coming year.

Student's Name __________________

Date of Birth ____/____/____

__________________ (Student Name) is recommended to be placed in ____ (Grade) for the _________ school year.

Conference Date _______________

Reason(s) for Recommendation of Placement by Teacher: