STUDENT INFORMATION FORM 24/25

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Please tell us about your little Viking! If you have more than one child in Early Childhood please fill out one form for each child.

Full Name (First, Middle, Last) *

Nickname or Preferred Name

Grade Level *

Pre K2

Pre K3

Pre K4

Primary language spoken at home: *

Other languages spoken:

Parent/Guardian 1 *

Parent/Guardian 1 Relationship to Child *

Parent/Guardian 1 Local Phone Number *

Parent/Guardian 1 Email Address *

Parent/Guardian 2 (if applicable) *

Parent/Guardian 2 Relationship to Child

Parent/Guardian 2 Local Phone Number

Parent/Guardian 2 Email Address

Child lives with: *

Has your child attended school before? If so, where and for how long? *

How does your child handle separation? How can we best support you and your child with the transition to school? *

Does your child nap? If so, for how long? *

What three words best describe you child's temperament or personality? *

What are your child's favorite activities? *

How does your child communicate their needs? *

Does your child have any fears? Or extreme dislikes? *

When you child is upset or frustrated what helps them calm down? *

Does your child have any identified areas that may require accommodation and/or that we should be aware of (for example, a speech delay, vision or hearing impairment, or are receiving therapeutic services or counseling, etc.)? Please explain: *

FAMILY

Please share a little about your family. Who lives in your household? Do you have other children (names/age)? *

What is important for us to know about your family's culture, religion or lifestyle? *

What activities do you like to do as a family? *

Anything else you'd like to share? Have there been any recent events that may impact your child's experience (move, new baby, change in family situation)? Please explain: *

HEALTH

Does your child have any allergies? If yes, to what? *

Does your child have an existing illness or condition? *

Is there anything else about your child's health we should be alerted to? *

*You have shared detailed health and immunization information with our school nurse. Important details related to allergy and asthma plans, medications, etc. will be shared with our teachers who are First Aid and CPR certified.

TOILETING AND SELF-CARE

*Children entering Pre K3 and Pre K4 must be toilet trained prior to enrollment

For Pre K2: Is your child toilet trained

What words does your child use to communicate that they need to use the toilet or have their diaper changed?* *

Is your child able to dress and undress themself? *

EATING

What are your child's favorite foods? *

Are there foods your child does not like?Are there any dietary restrictions or observances we should be aware of (i.e. vegetarian, kosher, halal diets). Please be specific: *

Does our child use utensils, eat with fingers, feed themself? *

COMMUNICATION

What are your hopes and/or goals for your child this year? *

Do you have any concerns about your child or the transition to school? *

If we have information or a concern we need to share in a timely manner, who should we reach out to first? Phone call or email? *

Please provide an emergency contact person, other than a parent. Please include: Name, Phone number, relationship *

Please provide an alternate pick up person(s), other than a parent. Please include: Name, phone number, relationship: *

Please sign & date : *

THANK YOU FOR TAKING TIME TO SHARE THIS INFORMATION!

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