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* 1. What is your full name?

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* 2. What is your child's full name?

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* 3. What are your child's greatest strengths?

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* 4. What are some areas that are challenging for your child?

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* 5. My child's interests and hobbies include:

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* 6. How does your child typically handle conflict with peers and parents?

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* 7. Does your child have difficulty completing tasks? Please elaborate.

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* 8. Have there ever been any concerns brought to your attention by previous teachers (academic, social, behavioral)? If so, please explain.

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* 9. What have been your child's past experiences in school or in enrichment activities?

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* 10. Do you plan to enroll in our after school childcare program? Please note, answering "yes" to this question now does not guarantee enrollment in our after school program.

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* 11. My primary reason for enrolling my child at Bridges is:

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