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* 1. Child's Name 

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* 2. Gender

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* 3. Birthdate

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* 4. Preschool Experience Yes or No?

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* 5. Who does student live with?

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* 6. Is your child currently receiving special assistance? Yes or No?

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* 7. What does your child enjoy doing?

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* 8. What are your child's strengths?

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* 9. Is your child independent when it comes to personal needs? Toileting, putting on coats, etc.

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* 10. Please share anything else you feel is important and pertinent for us to know (such as adjustments, concerns, or expectations).

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