1R Questionnaire 23-24
Dear 1R Families,
I am so excited to meet your first grader!  To help me prepare for this upcoming school year, please complete this form.  This information will help me learn more about your family and how best to communicate with you.  Note: your responses are exclusively for my own classroom use.
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Student First Name *
Student Last Name *
Preferred Name/Nickname
How should I label your child's folders, table spot, etc.?
What are your child's preferred pronouns? *
Child's Birthdate *
MM
/
DD
/
YYYY
Parent/Guardian 1 *
First and Last Name
Parent/Guardian 1 *
Relationship to Child
Parent/Guardian 1 *
Email
Parent/Guardian 1 *
Phone Number (xxx) xxx-xxx
Preferred mode of communication for Parent/Guardian 1
Clear selection
Parent/Guardian 2
First and Last Name
Parent/Guardian 2
Relationship to Child
Parent/Guardian 2
Email
Parent/Guardian 2
Phone Number (xxx) xxx-xxx
Preferred mode of communication for Parent/Guardian 2
Clear selection
Siblings at Heath
List name(s) and age(s). If at Heath School, please indicate grade/homeroom.
Does your child have any allergies or health concerns?
If so, please list below
Primary language spoken at home
Any additional languages spoken at home?
Are there any religious or cultural holidays that your family celebrates that aren’t recognized on the school calendar?
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