Home Address (Residential Parent/Guardian Address) *
Your answer
Mother/Guardian First and Last Name
Your answer
Mother/Guardian Email Address
Your answer
Mother/Guardian Phone Number
Your answer
Father/Guardian First and Last Name
Your answer
Father/Guardian Email Address
Your answer
Father/Guardian Phone Number
Your answer
List other children in the family and their age
Your answer
Where is your child attending preschool? If your child is not attending preschool, write "none" in the space provided.
Your answer
Describe your child's preschool experience this year. Include # of days/week, amount of time/day, in person or virtual - or write "none" if your child is not attending preschool.
Your answer
Please tell us about any significant experience your child may have had recently with a death in the family, divorce in the family or a major illness in the family.
Your answer
Please tell us about any health conditions, allergies or problems that your child has.
Your answer
How would you best describe your child's general personality? (i.e. competitive, shy, perfectionist, cheerful, has trouble sharing, etc.) *
Your answer
Which of the following daily living activities is your child able to do independently? Check all that apply. *
Required
Tell us about experience your child has had using technology (i.e. apps for fun, preschool online learning during stay-at-home order, online books/read aloud, facetime/zoom/live communication, etc.) and how they responded to it. *
Your answer
Tell us about your child's interests, hobbies and activities that are non-school related. *
Your answer
Is there something you would like us to know about your child that we have not asked?
Your answer
What are your hopes and expectations for your child's kindergarten year in school? *