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All About Me
I would like to learn about your child. Please answer the following questions.
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Email
*
Your email
Your Child's Name
*
Your answer
Nickname
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Your answer
Parent email to be included for a class list and for teacher use.
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Your answer
Birthday
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Your answer
What is your child's school district?
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Your answer
My child will be a Walker ALL Year and will NOT use the bus.
Yes
No
Clear selection
What Church baptized your child?
*
St. Patrick Church Smithtown
Other
Allergies? Please list all. (Is medicine in the nurse's office?)
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Your answer
Does your child have any health issues or concerns? Do they take medicine daily?
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Your answer
Did your child attend Nursery or Pre-Kindergarten Program
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Yes - Full-time Nursery School
Yes - Part-time Nursery School
Yes - Full- time Pre-K
Yes- Part-time Pre-K
No, my child has not attend school yet
Other:
Name of Nursery School
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Your answer
Name of Pre-K School
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Your answer
Has your child ever received educational, speech or early intervention services? If so, when and how long?
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Your answer
Who lives in my house? (Parents, siblings (ages), or grandparents)
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Your answer
Dad's occupation:
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Your answer
Mom's occupation:
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Your answer
Parents' religion:
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Your answer
What are your hopes for you child this year?
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Your answer
What are some things your child enjoys doing:
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Your answer
What is something your child likes to talk about?
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Your answer
Every year we distribute a “Friendship List” to each child in kindergarten. We include the name, address, phone number, parent emails and parents' names. Would like your child to be included?
*
Yes
No
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