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Parent Questionnaire
INSTRUCTIONS:
This questionnaire is
required
for your file to be considered for admission to Vanguard School.
You will be able to save the progress of your questionnaire if you are signed in to a Google account. Otherwise, please plan to complete it without interruption.
This questionnaire will be automatically added to your child's admission file.
The information provided will become part of the student’s file and will remain confidential.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
1. IDENTIFICATION OF STUDENT
Last Name
*
Your answer
First Name
*
Your answer
Other(s)
(As written on the birth certificate)
Your answer
Date of birth
*
MM
/
DD
/
YYYY
Permanent code
*
(As indicated on report card)
Your answer
2. PERSONAL DEVELOPMENT
Do you perceive your child as...
*
Check the statements that apply to your child, from your perspective.
Motivated to learn/curious
Responsible
Overly concerned with perfection
Overly sensitive when something goes wrong
Having difficulty expressing self
Having difficulty understanding what is said
Having difficulty with fine motor activities (cutting, writing)
Having difficulty with gross motor activities (swimming, jumping)
Lethargic
Inattentive: easily distracted by noise
Inattentive: daydreams
Overly sensitive to noise
Hyperactive
Impulsive
Oppositional/defiant
Having temper tantrums
Aggressive
Withdrawn
Anxious or nervous
Often sad
Sensitive to changes in routine
Sensitive to the feelings of others
Being sociable and having friends
Required
Comments, if any
Your answer
What are your child’s PERSONAL strengths and challenges?
*
Your answer
What are your child’s interests?
*
Your answer
How does your child feel about themselves?
*
Your answer
Do you have any specific concerns (other than academic) regarding your child? What do you think is causing these problems?
*
Your answer
3. PROFESSIONAL CONSULTATION OR ASSESSMENTS
Has your child had professional consultations IN CONNECTION WITH HIS OR HER LEARNING DIFFICULTIES, and could an evaluation report resulting from these meetings be useful to us in better understanding and supporting his or her academic learning?
Please specify the field of expertise of the professional consulted and send us the evaluation reports relevant to your child's academic progress.
Professional
Example: Psychologist, Neuropsychologist, Speech Language Therapist, etc.
Your answer
Year of written report
Your answer
Authorization to contact the professional if we need further information:
Yes
No
Clear selection
Would you like to enter information for other professionals?
*
Yes
No
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