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Candidate Data:
First Name: 
Last Name: 

Date of Birth:









Chesterfield School



Guardian Info:

First Name:


Last Name:



320 River Rd.

W. Chesterfield



Guardian/Family Phone:

Guardian/Family Email Address:


Living Situation:


Grandma has received guardianship a few months back. Prior guardianship as an aunt. Student currently living with Grandmother, Grandfather (Alzheimer's), Bio mom and Boyfriend. It is a new living arrangement.

Financial Situation:



Free/Reduced Lunch:






How many live in the household?


How many work and/or provide income to support the household?


Household Situation:

Riley lived with his aunt in Swanzey, NH starting in 2nd grade through April of his 5th grade year. His aunt had guardianship. I am not sure who else resided in that home. He shares that he visited with his bio mom periodically during that time. Dad is not known or involved to my knowledge.

In April 2021, Grandma became Riley's legal guardian and he moved in with her in Chesterfield, NH. The people in his home are: Riley, Grandmother, Grandmother's boyfriend, Biological mother and mothers boyfriend, Zack. Grandmother shares that the home environment is "strained". Grandmother's boyfriend has significant Alzheimer's which requires around the clock care. Riley's youthful addition to the home can trigger "episodes" for grandfather that add a difficult layer for all.

Organizations / Mentor Programs:

Riley played soccer this fall with the parks and recreation program in town. He enjoys riding his bike and asks to be dropped at the bike park in Keene, NH whenever it's open and he can be.

Special Assistance:

Riley transitioned to us with a 504 plan and related accommodations for Anxiety and inattention. He sees the school counselor for check-ins and self advocacy work related to his 504 plan.

Health Concerns:

Anxiety diagnosis is shared by family. They explored ADHD but felt inattention is more likely related to anxiety.

Victim of Sexual Abuse:

None known

Perpetrator of Sexual Abuse:

None known

Victim of Physical Abuse:

None known.

Threatening or Aggressive Behavior:

On rare occasions, Riley can "posture" using body language to assert his anger/frustration. On our school bus, Riley shared with me that another student repeatedly taunted him and he hit the other student after attempting to get adult help. No injuries were reported but Riley did get suspended from the bus.

When really angry, I have seen him work hard to manage his emotions. One time, I did see him hit himself in an attempt to manage big feelings. This was witnessed by me during an interaction around family dynamics.

Required Physical Restraint:


Personality / Social Standing:

Riley's life has presented many challenges. He has tremendous empathy for others as they navigate life. Riley is well-liked by many peers and considered "a good listener". I've noticed that several of our middle school girls turn to him for advice with social conflicts, crushes, family struggles and life in general. Riley seems to hold their information in confidence and has built himself a reputation as trusted confidant.

He is included in the classroom and has friends He recently advocated to work with another student after school in attempt to increase his math grade.

Riley can be extroverted when comfortable and confident. When he is faced with big emotions, he can present more introverted as he works to manage those.

Behavioral Patterns:

Riley has some classroom behaviors that can be common in middle school, especially when attending is difficult and the work doesn't come easy. He's chatty and distracted, at times. When he has a trusting relationship with the adult, he responds well to redirections, even if frustrated. When he perceives that he isn't liked by an adult or doesn't have an established relationship (sometimes seen with substitute teachers) he can argue with adults or refuse to follow directions. This has led him to principals office or a lunch detention on occasion. This behavior is mostly managed in the classroom setting due to relationships. I only see two visits to the principal this school year noted in our PowerSchool entries.


Riley's changing custody arrangements in his elementary years have been a challenge. While I don't know every adult he has interacted with, it seems like strong positive male role models have been lacking. I have a good relationship with Riley and with that relationship he is receptive to talking about life, hard emotions and even reflecting on places he can grow and do better.

Riley is the only child in the home. Grandmother, Riley's legal guardian, is often consumed by providing care for her partner with Alzheimer's. She shares that her boyfriends care can be all-consuming. Bio mom and her boyfriend do live in the home and despite not having guardianship are working to re-integrate and be involved with Riley.

Riley is a fun, adventurous and athletic kiddo who I feel would be a great match for The Mayhew Program and fully immerse himself and all you have to offer. I would be happy to answer any questions about Riley. The opportunity to participate could be a life changing experience for this kiddo!
Becky Kohler
603-363-8301 x2034