Student Information Questionnaire
Please complete this form if you have children in Temple Judea's Religious School, Confirmation Academy, Teen Assistant Program or Youth Group.

These questions will help us better understand and plan for your child. All information will be kept strictly confidential.
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Child’s Name *
Person competing this questionnaire & your relationship to the child? *
What weekday school does your child attend?
Does your child have any allergies or food restrictions?
Does your child have any Health Concerns or take any Medication that might impact their Religious School experience?
Does your child have any particular strengths, qualities, skills, interests, or talents that we could able to tap into to help them be as engaged as possible in the Religious School Experience?
Does your child have any physical, cognitive, behavioral or social-emotional challenges that might impact their Religious School experience?
Are there specific physical, cognitive, behavioral, social-emotional areas in which your child would benefit from additional support?
Are there any family issues that it would be helpful for your child's teacher to be aware of, such as divorce, remarriage, death, recent move, illness, or income status?
Would you like to share any other information with us?
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