2008 Children’s Bio Card Questionnaire
FOR 6 – 12 YEAR OLDS
PART A :
Child’s Complete Name ______Child’s Age ______
(Please take a moment to double check the spelling, will be printed as written on image.)
Child’s Birthday (dd/mm/yy) ______Current Grade Level ______
(Complete Birthday is required, please double check for accuracy.)
Location of current home (ex: Plant City, South Tampa, etc.) ______
(Please be as specific as possible.)
Currently at a Group Home? Y or N If yes, Name of Group Home ______
Child’s School ______
Is this child part of a sibling group? Y or N
Please list the names and ages of the siblings: ______
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This child WOULD _____ or WOULD NOT _____ adopt separately from his/her siblings.
Does this child have special needs? Y or N If yes, please explain: ______
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PART A : Continued 2008 Children’s Bio Card Questionnaire
FOR 6 – 12 YEAR OLDS
Please answer the following questions as fully as possible. Focusing on the positive aspects of the child and identifying qualities that make him/her a unique individual will be a wonderful help in creating a dynamic and engaging biography.
1.) What are five of this child’s best characteristics?
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2.) What does this child excel at above all else? Please cite academic and social examples. (Example: math and reading; telling the truth, helping others, etc.)
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3.) In social situations, how does this child behave? (example: he/she is outgoing and friendly; shy and withdrawn; the entertainer and prankster, loving, etc.)
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4.) What makes this child unique?
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5.) This child is loved by others because ______
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6.) She/he should be proud of her/himself, because ______
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7.) This child would make an excellent daughter/son because ______
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8.) In the future, this child’s talents would be best put to use in the following ways (Example: helping others, entertaining, as a veterinarian, teacher, coach, artist, etc.)
______
Thanks for your time! Love, the Heart Gallery Tampa Bay
2008 Children’s Bio Card Questionnaire
FOR 6 – 12 YEAR OLDS
PART B: Please fill out with child, by asking the questions and transcribing.
1. What is your favorite animal and why? ______
2. What is your favorite game? ______
3. What is your favorite place? ______
4. List three things you love about yourself. (Example: funny, athletic, smart, etc.)
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5. What would you like to be when you grow up? ______
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6. What kind of music do you like? ______
7. What are your three favorite things to do? (Example: play outside, draw, play an instrument, etc.)
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8. Do you like to play sports? If so, which ones? ______
9. How would your best friend describe you? ______
10. In school, what are your favorite subjects? ______
11. What is your proudest accomplishment? (Example: winning a spelling bee, making the baseball team, learning how to multiply, reading a book in a couple days, etc.)
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12. List three of your heroes and/or role models. ______
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13. If you could have one great talent, what would it be? ______
14. What goal are you working toward this year? ______
17. What would you like your future family to know about you? ______
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18. Describe the kind of family you would like. (Funny, active, warm, religious, etc.)
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Fill in the blank:
On a rainy day, I like to ______.
On a sunny day, I like to ______.
I’m very special and unique because ______.
One of the most important things to me is ______.