Author: Kathryn Aitcheson

All About Me Loving Lions & Happy Hippos & Eager Elephants
Name of Child:______________________________________________________________________________
Prefers to be called:__________________________________________________________________________
Date of Birth:____________________________________Present Age:___________________Gender:________
Mother’s Name:_____________________________________________________________________________
Fathers Name:______________________________________________________________________________
School Attending in Kindergarten: ______________________________________________________________
What other Preschools/Child Care programs has your child attended: ___________________________________
List other children in the home:
First Name Age Grade in School
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
The following questions are designed to help us better understand your child in order to meet he/her needs:
Briefly describe an ordinary day in the life of your child:
What is your child’s favorite toy?_______________________________________________________________
What is your child’s favorite song?______________________________________________________________
What is your child’s favorite bible story?__________________________________________________________
What’s your child’s sport?_____________________________________________________________________
What is your child’s favorite pet?_______________________________________________________________
Who is your child’s favorite person?_____________________________________________________________
What is your child’s favorite book?______________________________________________________________
What does your child dislike:?__________________________________________________________________
Does your child have any particular habit or mannerism, such as thumb sucking, nail biting? Please describe:
Does your child have any particular fears such as dogs, sirens, thunder, etc. Please describe:
Does your child have any particular words or expressions that may not be understood by an outsider? Or speak a second language or uses sign language?
In general, how does your child react to anxiety or a stressful situation? Does he/she cry, withdraw, throw tantrums, etc. ?
What is your mode of reassuring and rewarding your child?
Are there additional circumstances regarding your child’s physical or emotional status that you want us to be aware of?
Does your child have allergies? Please list.
OPTIONAL: Is there anything else in your child’s development that you think we should know? Any special concerns or needs? ie. occupational therapy or physical therapy :
How would you like to see your child grow and develop during this school year?
NOTE: All students in the Busy Bears through the Pre-K classes must be potty trained by the
first day of Preschool, September 8, 2014.