Incoming Kindergartner Questionnaire
Parents: In order to help your child's Kindergarten teacher learn as much as possible about your child, please fill out this form completely. All information will be kept in the strictest confidence. It will be used only to gain a better understanding of your child as an individual. Thank you!
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Child's Legal First Name
Child's Last Name
Name child will be called at school and learn to write
Address
Home phone
Birthday
MM
/
DD
/
YYYY
Age when School Begins
Child Resides with
Mother's name
Mother's occupation
Mother's cell phone
Mother's work phone
Best time to call mother
Mother's email
Mother would like to be added to class distribution list
Clear selection
Father's name
Father's occupation
Father's cell phone
Father's work phone
Best time to call father
Father's email
Father would like to be added to class distribution list
Clear selection
List the names and ages of all children in your family (If any are at MBE, please list their grade level/teachers)
List other persons living in your home and their relationship
Approximate bedtime
Time
:
Arising time
Time
:
Does your child take a nap daily?
Clear selection
If so, how long?
Hrs
:
Min
:
Sec
Does your child have any allergies? (If so, please list.)
Does your child have any other health problems of which I should be aware?
Does your child complain about his/her health? (If yes, please explain.)
Does your child have any speech or hearing difficulties or has he/she ever received help for any? (If yes, please explain.)
Appetite
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Carpool Route (Heathermoor or Cambridge) and Number
If your child is in a carpool riding group, please list all members
List all preschools attended
Has your child attended a 5 year old kindergarten? If so, where?
Have your child's school experiences been positive?
Clear selection
What is your child's attitude toward coming to school this year?
Where do you see your child in 15 years?
Does your child have any fears?
Does your child have nervous habits (biting nails, sucking thumb, etc.)?
What are your child's favorite activities?
Daily time spent outside
Daily time spent watching TV
Daily time spent on the computer / iPad / other digital devices
What do you want your child to accomplish this year academically?
What other non-academic goal(s) do you want your child to accomplish this year?
Is there any other information you think would be helpful?
Submit
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