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Parent Survey

Complete and return the form on or before school begins.

Date___________________

Child’s name_________________________________

Language(s) my child speaks________________________________

Parent(s) name____________________________________________________

Information about your child
Name my child prefers to be called________________
One activity my child enjoys_____________________
A strength of my child__________________________
My child dislikes eating_________________________
My child is allergic to __________________________
My child avoids doing__________________________
My child goes to bed at _________________________
My child sleeps the whole night through
____usually
____sometimes
____nightmares
____wants to sleep with mom and dad
____going through a growing time now and has leg pains
My child is interested in________________________
My child loves to “read” (favorite memorized story)_____________________
My child loves to read (ready to read) ___________________
Please write other information about your child you would like me to know.

Parents have an opportunity to share their time with the children in the classroom
Please take the class Keeping Your Child Safe.

Share an art project using paper, paint, chalk, oil pastels_______________
Share a dance style related to a holiday or ethnic group_______________

Please check the following that you are interested in doing:
I am interested in reading to the class ______
Play a musical instrument________ (end of May and beginning of June)

Assist the Teacher
Copy papers_____ Note the day____________
Fill folders to go home_____ Friday or Monday morning____________(please
indicate your preference)
Help with Bulletin Board/cutting/ or suggested ideas______
I look forward to having my child learn about
______________________________________________________________

Please check one of the following:
This form
_________was helpful
_________would be more complete if this were added
_________other(specify)