2017-2018 Zeeland Christian Preschool Online Questionnaire
Welcome to Zeeland Christian Preschool! We are honored that you have chosen us for your child's preschool experience. The following questions will help us as we prepare to work with you and your family in the upcoming year.

The questionnaire will take you about 10 minutes to complete. Please be sure that you set aside time to complete it. You will NOT be able to save your responses and will need to start over if you exit the page. If you have difficulty filling this out, please contact Nancy Pyle at npyle@zcs.org.

The online questionnaire must be completed by July 31.

Child's First Name
Your answer
Child's Last Name
Your answer
Your Child's Teacher
Photo Release Information
Zeeland Christian School has a website and Facebook page for school families and prospective parents. They are updated with preschool information and pictures. The purpose of this form is to obtain permission for photos or video of your child to be placed on the website, Facebook page, or in other promotional materials. Children will be identified by first name only.

Preschool teachers also put pictures in their weekly newsletters which are emailed just to that group of parents. This form also gives permission to post photos of your child in the classroom newsletter.

Release
Selecting "yes" gives Zeeland Christian Preschool permission to use your child's picture on the school website, Facebook page, or in promotional materials. Children will be identified by first name only or not at all. Selecting "no" will prohibit the school from using your child's image on the website or in promotional materials.
Parent Initials
Your initials in the box below serve as an electronic signature regarding images and video of your child.
Your answer
Self Screening Form
Zeeland Christian Preschool is a non-profit, non-discriminatory preschool.

Michigan State law requires the licensing of all preschools through the Department of Licensing and Regulatory Affairs (LARA). Therefore, Zeeland Christian Preschool not only has its own policies, but also complies with LARA regulations, procedures, and policies. Some of these policies include: compliance with health and safety standards, on-site inspections by fire and health officials, classroom visits by LARA consultants, etc.

Certain screening procedures are required by LARA for all workers in the preschool program. As such, the following questions must be asked of our parents and other participants in our program before they can assist in the preschool classroom.

Please answer the following questions. Responses will be kept on file while your child is enrolled at Zeeland Christian Preschool. The answers given are confidential and only for the use of the administrator and LARA officials.

Parent/Guardian #1
Have you ever been convicted of an offense other than a traffic violation? Have you ever been involved in the abuse or neglect of children? Have you ever been charged with a felony involving the harm or threatened harm of an individual?
Parent/Guardian #1 Explanation
If you answered "yes" to any of the above questions, please list your name and explain the situation below.
Your answer
Parent/Guardian #2
Have you ever been convicted of an offense other than a traffic violation? Have you ever been involved in the abuse or neglect of children? Have you ever been charged with a felony involving the harm or threatened harm of a individual?
Parent/Guardian #2 Explanation
If you answered "yes" to any of the above questions, please list your name and explain below.
Your answer
Red Preschool T-Shirt Information
Preschool children wear T-shirts for field trips and other special events. If you have a red preschool t-shirt from a sibling or friend you do not need another one. Hand-me-downs will work fine!
Preschool T-Shirt
If your child needs a T-shirt, what size does your child need? (Only youth sizes are available, not toddler sizes, so most children get a size small, except some of the older children.)
Student Information
Please answer the following questions about your child. These things help us as we plan and prepare for the fall so that we are ready to help your child learn and grow throughout the school year.
Medical Background
Does your child have any allergies, medical concerns, or special needs?
Medical Explanation
If you answered yes to the above question, please explain below. Include if your child will need an emergency response plan at school.
Your answer
Place of birth
Where was your child born?
Your answer
Adoption
Is your child adopted?
Adoption Age
If yes, at what age was your child adopted?
Your answer
Language
Is any language other than English spoken in your home?
Language Explanation
If you answered yes to the above question, what language is spoken in your home?
Your answer
If there is any other information about your child that you would like to share with our staff before we approach the parent meetings and start of school, please feel free to include it below.
Your answer
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