Home
Teachers and Staff
Programs
Registration
Contact Us
My Account
My Account
Help Us Know Your Child!
My child is a…
*
3 Year Old
4 Year Old
Young 5
Child’s Birthdate
*
MM slash DD slash YYYY
Gender
*
Male
Female
Name of Child
*
What name do you want your child to write/recognize in class?
*
Mother’s Name
*
Father’s Name
*
LIST AND EXPLAIN ANY AND ALL ALLERGIES
*
MY CHILD WILL HAVE AN EPI-PEN AT SCHOOL
*
Yes
No
Was your child premature?
*
Yes
No
People in home
*
Mother
Father
Other Adults
Other children, specify names & ages
*
Language(s) spoken at home?
*
Occupation of Mother / Guardian
*
Occupation of Father / Guardian
*
Has your child had previous preschool experience?
*
Choose one...
No
Yes
Great! Where did your child attend?
*
Describe your child’s responsibilities at home
*
Does your child have any pets?
*
Choose one...
No
Yes
Types of animals & names
*
Does your child have any fears or anxieties?
*
Choose one...
No
Yes
Please specify
*
Do you feel your child is advanced in some areas?
*
Do you feel your child is delayed in some areas?
*
Does your child have any limitations that we should be aware of?
*
Does your child tend to be
*
right-handed
left-handed
both
not sure
List some specific behavior traits you have observed in your child such as shyness, outgoing, rebellious, etc.
*
Do you have any specific concerns about your child entering preschool?
*
List email addresses you would like to receive weekly classroom email communication:
*
List whom regularly will be dropping off/picking up your child(ren):
*
Do you have any specific concerns about your child entering preschool? Please use this space for additional comments which might be helpful to us in getting to know your child. Thank you!
*