Menominee County Kindergarten Parent Questionnaire
Please help us get to know your child by completing the questions below.
Your cooperation is greatly appreciated. This information about your child is very important and will help in planning educational experiences for the kindergarten classroom. We look forward to working with you and your child this coming year.
School attending for kindergarten
Child's name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Person completing this questionnaire.
Required
Please let us know who resides in your home.
Required
Who owns the home where you live?
Your answer
What is the total number of people living in your home?
Your answer
Primary language spoken at home
Your answer
Other languages spoken at home
Your answer
Do you have concerns about your child’s development (speech/language, gross or fine motor, comprehension, problem solving, relationships with adults and peers)? If yes, please explain.
Your answer
Has your child attended preschool, daycare, playgroup or an organized sport/creative arts activity?
Required
If you checked preschool or daycare above, please tell us the name and location.
Your answer
How often did your child attend any of the above?
Your answer
Please describe your child’s experiences at preschool, daycare etc. What did they enjoy most? Were there any challenges/concerns?
Your answer
I give permission for the kindergarten teacher to contact my child’s previous school, daycare or group to request information about his/her early learning experiences.
Please list activities or special hobbies/interests your child engages in most often. (examples: coloring, playing outside, electronics, trains, watching tv, looking at books)
Your answer
How often is your child read to? What are his/her favorite books?
Your answer
Do you have any concerns or information that should be shared regarding your child’s behavior/social skills (example: tantrums when told “no”, has difficulty sharing)
Your answer
Does your child have any medical conditions or allergies?
Your answer
Does your child have any food related issues (dislikes certain textures, refuses to eat, etc)
Your answer
Which of the following skills have you helped your child acquire?
Required
If your child recognizes letters of the alphabet, please list them below.
Your answer
If your child counts, please tell us to what number he or shes counts accurately.
Your answer
This year in kindergarten, I would like my child to
Your answer
Is there anything else that you would like to tell us about your child?
Your answer
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