Preschool Questionnaire

  • Anyone interested in joining one of our Preschool Alternative programs can optionally fill out the questionnaire below so that we can get to know a little bit about your child before he/she attends. If you have any questions, please feel free to contact us at 212.396.0830.

    Child's Information
    Child's Last Name*
      Child's First Name*
      Birth Date*
    Age at Start*
    Parent Informaiton
    Parent's Last Name*
      Parent's First Name*
    Home/Main Phone*
      Business Day Phone
    Cell Phone
    Parent's Last Name
      Parent's First Name
    Home/Main Phone
      Business Day Phone
    Business Day Phone
    Street Address*
      Zip Code*

    Email Address*

    Please provide us with at least one email address so we can update you on snow days and special events at our school.

    Program Informaiton


    Application Questions
    (1) Has your child participated in any other group learning activities? Please describe his/her experience(s).*

    (2) What are your child's strengths and main interests?*

    (3) Please describe your child’s personality (including any special needs).*

    (4) What family activities does your child enjoy?*

    (5) What goals do you have for your child while in Preschool?*

    (6) Is English your child's first language?*

      If no, what is your child's first language?

    (7) Will your child need medication administered at the LWFC preschool?*

    If yes, please specify and detail

    (8) Does your child have allergies that could affect him/her at the LWFC preschool?*

    If yes, please specify and detail

    (9) Is there anything else you'd like to tell us about your child's readiness to participate in a language immersion or alternative preschool?

    Guardian Information (If you are the guardian, please fill in your main contact information below.)
    Last Name*

      First Name*

    Phone Number*

      Email Address*

    Other Persons Authorized For Pick Up (If Applicable)
    Last Name

      First Name

    Phone Number



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