Lil' Royals Preschool Enrollment 2020
On Sept. 15, 2020 how old will your child be? *
Child's full name. *
Your answer
Preschool Options (half day 8:30-11:30) (full day 8:30-3:30) *
Are you interested in receiving information about an income based tuition scholarship? *
Child's birthdate. *
Your answer
Father or Guardian full name, address, and phone number. *
Your answer
Mother or Guardian full name, address, and phone number. *
Your answer
Preferred email address. *
Your answer
Physician's name and phone number. *
Your answer
Please list all allergies with reaction description. (ex. hives: trouble breathing) *
Your answer
Medication taken at home. *
Your answer
Medication needed at school. *
Your answer
Medical History: Check all that apply...
Medical History: Please explain any medical issues your child may have. *
Your answer
Is your child still learning to use the toilet? *
List any concerns you might have about your child's general growth/health or development. *
Your answer
Please tell us about your child's previous childcare/educational experience. *
Your answer
Language Development *
Yes
Sometimes
No
Understands spoken language well
Is able to follow directions
Speaks clearly: is easily understood by a new person
Expresses needs adequately
Able to express ideas clearly
Asks questions
Remembers past experiences
Looks at books
Looks at pictures you point to in books
Physical Development *
Yes
Sometimes
No
Plays with clay or playdough
Cuts with scissors
Puts 6 piece puzzle together regularly
Climbs on playground equipment
Rides a tricycle/bike
Plays with blocks
Catches a ball
Enjoys paper/pencil/crayon activities
Social -Emotional Development *
Yes
Sometimes
No
Looks you in the eye for more than a few seconds
Separates from parents easily
Takes turns with other children
Plays cooperatively with other children
Stays with an activity for at least 10 minutes (not electronics)
Handles frustration well
Falls asleep at night at regular bed-time
Undresses self without help
Dresses self without help
Takes care of personal needs (toileting, wash & dry hands)
Feeds self regularly using a spoon an fork
Eats dinner regularly at the same table with family
What is your child's favorite book? *
Your answer
What is your child's favorite indoor activity? *
Your answer
What is your child's favorite outdoor activity? *
Your answer
How many hours a day does your child spend watching tv, on a tablet/phone, or play video games? *
Your answer
How often does your child play with other children? What age child does your child play with most often? *
Your answer
Has anyone had any reason for concerns about your child's behavior? Please explain *
Your answer
What activities do you and your child like to do together? *
Your answer
What things can your child do well? *
Your answer
What things are difficult for your child? *
Your answer
Does your child have any fears? *
Your answer
How does your child express anger? *
Your answer
Is there anything else you would like the teacher to know about your child?
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Colo-Nesco Community School. Report Abuse