2017 - 2018 Family Information Sheet
Please complete the following form (one for each child attending) to help us get to know your child better. If you feel uncomfortable answering any questions, please feel free to skip those that you feel are too personal. This information is our way of getting to know the most important information about your child to better plan for his/her needs while at Northbrook Preschool.
Child’s Name ______Nickname______
(First)(Last)
Parents Names ______
(Mom’s first name)(Dad’s first name)
Child lives with (Please check one)
□ Mother and Father □ Mother □ Father □ Grandparent(s)
□ Other (Please list) ______
What name does the child call mother?______father?______
Are there brothers and/or sisters at home? ______Names and ages of brothers/sisters______
______
______
Primary language your child speaks at home______
Does your child have a pet? ______If yes, what is the animal and what is it’s name?
______
Who is your child’s favorite playmate? (Name, age, and how often they play) ______
______
Does your child have a special item for comfort such as a blanket or stuffed animal? ____
If yes, what is it and what does your child call this item?______
______
What does your child say when he/she has to go to the restroom?______
______
What term does your child use for urination?______
What term does your child use for a bowel movement?______
What is your child’s bedtime?______What time does your child wake in the
morning?______Does your child take a nap?______For how long?______
Does your child sleep alone?______If no, with whom does your child sleep?______
______
What is your child’s favorite television program? ______
How much television does your child watch a day?______
What are your child’s favorite activities? ______
______
What are your child’s favorite foods?______
Please list any special food dislikes______
Please list any food allergies______
Does your child have any jobs or chores that he/she does or helps to do? ______
If yes, please list them______
______
Does your child have any particular fears?______If yes, please describe the fears.
______
Does your child have any special medical problems or special needs? Please list. ______
______
What holidays and special occasions do your family celebrate during the year?______
______
What hobbies, talents, skills, profession, or interests do you have that you might be willing to share with your child’s class or with the school?
______
______
What other information can you provide that will assist us in meeting your child’s needs (i.e., child was adopted, expecting new baby, parents are separated, grandparent lives with family,nanny keeps children during day, special behavioral considerations, etc.)?
______
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