2019-20 3C Welcome Questionnaire

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Please take a few minutes to complete the following form by Monday, August 5th. If you have any concerns with the survey, please do not hesitate to reach out to me. I have required responses on most of the questions, to ensure that all important information is obtained. Please write NA if there is no applicable answer. We truly appreciate you taking the time to help us get to know your scholar better, save us a lot of paper, and make all of this information easily accessible!

Thank you and welcome to 3C!

Email *

What is the fastest way to reach the emergency contact? Please include: name, method of contact, and any special instructions (extensions, etc). *

Scholars Name: (Last, First) *

Scholar's Birthday: *

Mother/Guardian's Name: (Last, First) *

Daytime/Work Phone:

Cell/Additional Phone: *

What is your preferred method of contact: *

Daytime/Work Phone

Cell/Additional Phone

Father/Guardian's Name: (Last, First) *

Daytime/Work Phone:

Cell/Additional Phone: *

What is your preferred method of contact? *

Daytime/Work Phone

Cell/Additional Phone

Step parent/s or additional guardian name and relevant information. *

Scholar lives with: *

Both Parents

Mother

Father

Legal Guardian

Who should be contacted when information regarding your child's progress needs to be communicated home? *

Mother/Guardian #1

Father/Guardian #2

Contact both parents separately

Other:

What time will your child be picked up from school? (Please select "other" and explain if pick up schedule varies, child will ride in a carpool, child will attend clubs, etc.) *

3:05 DRIVE UP

3:05 WALK UP

3:25 with prep school sibling

Athenaeum

Other:

Do you foresee your child needing additional academic support? Please explain any subject areas of concern and why. *

What academic goals would you like to see your child accomplish this year? *

What behavioral goals would you like to see your child accomplish this year? *

Please use this space to tell me anything else you'd like for me to know about your child, family situation, background, etc. *

Does your child have any severe food allergies, dietary needs, or other health concerns to note? (Please visit Nurse Hodgkins if you have not already.) *

I am interested in volunteering for the following: (Volunteers must have a fingerprint clearance card on file with the front office.)

I am interested in being a class parent

Math Groups ( Wednesdays 7:55-9:00am)

Class Parties (about 1 per quarter)

Class Field Trip

I can make copies or assist with projects for you about once a week

I cannot make it into the classroom, but I would enjoy assisting with projects at home

My fingerprint clearance card is: *

On file with the front office already.

Being processed.

What is a fingerprint clearance card?

I give you permission to put photos of my child on the classroom website. (Photos will only be accessible by those that have the link to the class blog. This is separate from the school website, Facebook, etc.) * *

Yes

Our birthday treat policy has changed. The academy suggests non-food items for birthdays or healthy snacks (e.g. stickers, pencils, a favorite book donation to the classroom library). However, please read and follow these guidelines if an exception is made: *

I understand that food must be in its original packaging with the ingredients listed. (Fresh fruit is the exception.)

I understand that snacks should not contain peanuts or other nuts. **Item must be from a nut free facility.

I understand that no cupcakes, cakes, cookies or other sweet treats with frosting are allowed.

Required

This form was:

Too long (My apologies, but we saved a few trees!)

Too short (I will reach out to you to address any additional concerns.)

Just right! (Yay!)

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