This questionnaire is for my personal files on your child.  Please fill out and return when you come to Open House.  Thank you!

 

Name of Child________________________________Birthdate________

Name Child Goes By___________________________________

Name of Mother_____________________________Occupation________

Name of Father_____________________________Occupation________

Address________________________________Home phone__________

Work No., Cell No. Father_____________________________________

Work No., Cell No. Mother_____________________________________

Describe your child’s personality (Strengths, weaknesses, areas needing improvement):

_________________________________________________________

_________________________________________________________

_________________________________________________________

ALLERGIES, SPECIAL CONDITIONS, FEARS, ETC:

 _________________________________________________________

 _________________________________________________________

Did your child attend Pre-K? (Please attach a copy of the Pre-K report card.

________________________________________________________

Does your child know the alphabet and sounds?______________________

Numbers?_________________________________________________

Can your child read?_________________________________________

Responsibilities at Home:_______________________________________

Best way you’ve found to discipline your child:_______________________

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