Kindergarten Round-up – Additional Information

1. Child’s Legal Name:

Name to be used at school:

2. Preschool Experience:

a) Name of preschool:

b) Years attended:

c) Number of hours per week:

3. Childcare in private home:

a) Years:

b) Number of hours attended per week:

4. Other child care or educational experience:

5. Any other information which would be beneficial for the teacher to know

in order to best meet the needs of your child (health concerns, behaviors, family issues, etc.

6. Any known food allergies? Yes No

Please explain: