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*
    Gender*
      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*
      City*
    State*
      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

    Program*

     
    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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