Getting To Know You...getting to know all about you
**Kindergarten Student Information**

  choose one 4 5 6

Family Background

Family Pets  yes    no

If yes, list animal(s)

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Academic Background 

Pre-school experience   choose one yes no

Where?

How long? 

Can your child recite their full name?                  yes     no

Does your child know their phone number?       yes      no

Does your child know their full address?              yes     no  

Does your child print their name using upper and lower case letters? 

 yes no

Does your child recognize numbers 1-10?               yes     no

Does your child recognize the alphabet?               yes     no

To what degree?all letters  most letters  some letters not at this time

Is your child independent in the bathroom?    yes     no

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Student's Health Background   

Does your child have any allergies?    yes   no

If yes, please describe.

Does your child observe any food restrictions due to religion?  

 yes         no

If yes, please describe.

Does your child have any illness or health ailments that will need special considerations at school?               yes     no

If yes, please describe.

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Parent Information

Father:  First name    Last name

Home Address

Home Phone # Sample: (973) 777-7777

Cell #--  Work #  

Mother:  First name Last name  

Home Address

Home Phone #Sample: (973)777-7777

Cell #  Work #

Any other language spoken at home other than English?             yes      no

If yes, which one?