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About
About Us
Careers
Hands On Minds On
Why Choose Us
Where Are They Now?
Smart Start Healthy Kids Initiative
The Safe Side
Meet The Staff
Staff Portal
Parent Reviews
Tuition Support
Parent Education Classes
Programs
Early Toddlers
Toddlers
Preschool
VPK
School Age
Summer Camp
For Our Parents
Parent Corner
Enrollment Paperwork
Covid Health and Safety Guidelines
Covid Updates
Careers
Contact Us
Call
Map
Inquire Now
About
About Us
Careers
Hands On Minds On
Why Choose Us
Where Are They Now?
Smart Start Healthy Kids Initiative
The Safe Side
Meet The Staff
Staff Portal
Parent Reviews
Tuition Support
Parent Education Classes
Programs
Early Toddlers
Toddlers
Preschool
VPK
School Age
Summer Camp
For Our Parents
Parent Corner
Enrollment Paperwork
Covid Health and Safety Guidelines
Covid Updates
Careers
Contact Us
Menu
About
About Us
Careers
Hands On Minds On
Why Choose Us
Where Are They Now?
Smart Start Healthy Kids Initiative
The Safe Side
Meet The Staff
Staff Portal
Parent Reviews
Tuition Support
Parent Education Classes
Programs
Early Toddlers
Toddlers
Preschool
VPK
School Age
Summer Camp
For Our Parents
Parent Corner
Enrollment Paperwork
Covid Health and Safety Guidelines
Covid Updates
Careers
Contact Us
PARENT QUESTIONNAIRE
Your answers will help us get to know your child better and to make some projects with her/him. Some questions we will used in order to show respect to your family culture, practices, or family makeup.
Please enable JavaScript in your browser to complete this form.
To know you better:
Parent One
Parent Name
*
Date of Birth
*
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Place of Birth
*
Job
*
Your parent’s place of birth
Parent Two
Parent Name
*
Date of Birth
*
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Place of Birth
*
Job
*
Your parent’s place of birth
Please circle the family make up that best describes your home. This will help us with projects such as Mother’s Day and Father’s Day:
Mom & Dad
Mom & Mom
Dad & Dad
Mom only
Dad only
Lives with grandparents
Foster child
Yes
No
What does the child call you?
Divorced
Yes
No
Who is the child living with and do they have contact with the other parent?
Main language spoken at home
Dietary restrictions
Special holidays Celebrated
Special Customs your family observes
Are there any holidays or activities you do not wish your child to participate in?
Would you be willing to share something about your culture with the class?
Special words or phrases you use with your child and their meanings
Is the child living with both parents?
Yes
No
To know your child better:
Was your child born prematurely?
Yes
No
How many weeks?
Does your child have sister(s)/brother(s)?
Yes
No
what is his/her birth order?
How many? What are their names?
Does your child have a special habit for sleeping/nap time?
(i.e.needs pacifier, stuffed animal, etc.)
Any other routine preferences?
Does your child require or receive any services, including speech and language, occupational or developmental therapies?
Does your child need help to eat?
Does your child have a special diet or allergy?
Yes
No
Please describe:
Special Toileting Preferences
(i.e. boys use urinal or sit to urinate)
Submit