Family Info Survey
To help me better support your child, please provide answers to as many of the following questions as possible.
 Your answers will be a big help as I get to know your child and help him or her to maximize learning this year!


I look forward to getting to know your amazing child and working with your family to further your child's education during the coming year!

Virginia Horak
HorakVi@boe.richmond.k12.ga.us

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Email *
Who is completing this form? *
What is the name of your second grader? *
How will your child arrive at school? *
How will your child leave school? *
If your child rides the bus, please provide the correct bus number(s) or the name of daycare center.  Please provide both the AM and PM bus numbers if they are not the same.
What is the best way to contact your family for DAY-TO-DAY communication? (Please put contact name beside your number or email address.) *
What is the best way to contact your family in an EMERGENCY?  (Please put contact name beside your number.) *
Is your child left-handed or right-handed?  (Seems like a funny question, but knowing helps me support their fine-motor skill development better!)
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What language(s) does your family speak at home besides English?
Where else has your child lived besides Augusta?
Please list any allergies or medical concerns.
What does your child like about school?
What does your child like to do outside of school?  (Please be as specific as possible.  I'd love to know what sports, t.v. shows, games and toys and hobbies they enjoy.)
What are your child's greatest strengths?
What is your child's greatest weakness?
To which of the following technologies does your child have consistent access?  (This will help me support your family better in case of a need for on-line schooling or support.)
What other information or concerns would you like to share with me?
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