Grown Up's Name(s) and relation. Please include anyone who will be regularly dropping off/picking up your child. *
Your answer
Class *
Child's Date of Birth *
MM
/
DD
/
YYYY
Preferred Nickname (name you want to be on your child's name tag)
Your answer
My child is *
If other was selected above. Please tell us more.
Your answer
Please describe your child as objectively as possible. Please be sure to include abilities, strengths, challenges, and attitudes. To help get you started: My child enjoys_____. My child does _______ well. My child needs help with_____. *
Your answer
What are your goals for your child this school year? What concerns can we help to address? *
Your answer
What are your child’s emotional triggers? How do they cope? (hides/ wants a hug/ left alone) *
Your answer
Please list any siblings and their ages. Feel free to share pets too!
Your answer
My child likes (favorite characters/ stories/ songs/ activity) ______. My child does not like (fears/ finds ___ upsetting)____________. *
Your answer
Please list and food allergies or dietary information.
Your answer
Previous school/ class experience?
Your answer
Speech/ OT/ IEP/ IFSP/ Child Find Information?
Your answer
Please provide information for any specific individual needs we should be aware of at school.
Your answer
We often find that our parents have special abilities that aid our students, our facility and our program from time to time. Do you have an interesting job that could be shared with the children? Does your job give you specialized skills that might be useful for projects at Magothy? Do your talents lend to something special to contribute to our program? *
Your answer
Do you have any traditions you would like to share with our community?