Child's Name: *
Child's Date of Birth: *
Date Format: MM slash DD slash YYYY
Do you wish to have your child attend half day or full day? You may change your preference at the first of any month with approval. * Do you want for your child to be considered for the Early Arrival Program, provided there is space in the program? * Do you want for your child to be considered for the After School Program, provided there is space in the program? * TEMPERAMENT: *
Please describe your child’s temperament as observed thus far. How would you describe their social and emotional development? What calms or soothes your child when he or she is upset? How do you comfort your child? Does your child have any particular recurring fears?
SCHOOL/CARE EXPERIENCE: *
What is your child’s current care situation? Has your child had experience in a group-care environment or situation? How does your child handle separation?
What is the status of your child's toilet learning? Is he or she in diapers or pull-ups? If out of diapers, for how long (at home and at school)? If out of diapers, does your child have accidents/misses? Does your child need regular reminders to use the restroom?
If your child is entering Primary and is still in diapers or pull-ups, please note that your child will need to be potty-trained (in underwear for at least 3 months) prior to their first day of school. ORAL/VERBAL: *
Does your child feed himself or herself? Is he or she a picky eater or does he or she have difficulty eating independently? Does your child currently use a pacifier? How are your child's verbal skills?
SPECIAL CONSIDERATIONS: *
Are there any special considerations which you would like to share or additional information you feel would be important for us to know when considering your child’s classroom placement? Has your child been assessed, or recommended for assessment, for any reason, including, but not limited to speech or hearing, sensory integration, or behavioral challenges? If there are no special considerations, please write “none.”