Please help me get to know your child!

As your childs teacher, Id like this school year to be the best. Thats why Im asking for your
help. Ive found that the more I know about my students, the easier it is for me to help meet their
needs. For that reason, I would appreciate it if you could take the time to answer the questions below.
Of course, this is completely voluntary. Thank you so much for your time. Please return this form to
school as soon as possible.
Childs Name: _______________________________

Childs Birthday: _____________

Address: __________________________________
__________________________________
Home Phone Number: _________________________

Please indicate how your child will get

home from school.
*Bus Rider _______
If so, what bus number _______

Mothers Name: _____________________________

Mothers Work Place: ________________________

*Car Rider _______

*After School Program __________

Mothers Work Number: ______________________

Email Address: ____________________________

Fathers Name: _____________________________

Is there any other important information I

should know about your child? (i.e.
allergies, asthma, etc.)

Fathers Work Place: ________________________

________________________________

Fathers Work Number: ______________________

________________________________

Email Address: ____________________________

________________________________
________________________________

If parent is not available, whom should we call?

Name: ____________________________________
Relationship to child: _______________________

________________________________
________________________________
________________________________

Phone Number: _____________________________

Siblings living in the household:

Siblings not living in household:

Name ______________ Age ______

Name _____________ Age ____

Name ______________ Age ______

Name _____________ Age ____

Name ______________ Age ______

Name _____________ Age ____

What are your childs major strengths?

______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

Tell me about your childs interests and after school activities.

______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

Describe your childs feelings about school.

______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

Does your child have any problems with learning?

______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

How do you feel I (the teacher) can best help your child this year?
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

These questions were answered by ______________________ Relationship to child __________________