Ladd Kindergarten Parent Questionnaire
Please take a few moments to introduce your child to us through this questionnaire. The information you provide will be shared with the classroom teacher and other school staff members who will be working with your child. Thank you for providing this information.
Child's Name
Your answer
Name to be called if different
Your answer
Date of Birth
Your answer
Name of person completing questionnaire and relationship to child
Your answer
My child has participated in the following activities: (mark all that apply)
preschool/day care
play group
in-home child care
organized sports
creative/dramatic activities (dance, arts & crafts, music)
Other:
My child enjoys the following activities: (mark up to five)
looking at books
playing with puzzles
building with blocks
playing outside
coloring
using computer
watching television
imagainative play
listening to stories
using scissors and paste
Other:
My child will ask for help when needed from a familiar adult.
Choose
often
sometimes
seldom/never
Someone reads to my child.
Choose
often
sometimes
seldom/never
My child separates easily from a parent.
Choose
often
sometimes
seldom/never
My child participates in daily family routines and chores.
Choose
often
sometimes
seldom/never
My child takes care of bathroom needs independently.
Choose
often
sometimes
seldom/never
My child enjoys playing alone.
Choose
often
sometimes
seldom/never
My child enjoys playing with other children his/her own age.
Choose
often
sometimes
seldom/never
My child follows two-step requests that are sequential, but not necessarily related (put away the toy and then go get your coat)
Choose
often
sometimes
seldom/never
My child stays interested in self-chosen activities for:
Choose
20-30 minutes
10-20 minutes
5-10 minutes
My child has a medical concern I would like to discuss before school begins.
Yes
No
Clear selection
5-year-old children exhibit a range of behaviors when they're angry. How does your child express anger? Disappointment? Frustration? Fear?
Your answer
If your child has a current IEP, or one in the past, please explain below.
Your answer
What do you feel are your child's strengths?
Your answer
What specific things would you like to see happen this year in Kindergarten?
Your answer
Anything else that you would like to share:
Your answer
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