1-S Parent Questionnaire & Survey

Dear Parents,

Throughout the year we will need your help. Please look over the following list and mark any of the activities you are willing to help out with.

Field Trips

I can drive for field trips (my vehicle will hold children and their booster seats)

I can help chaperone on field trips, but am unable to drive

I can help call and set up field trips/classroom visitors

My Time

I can call other parents and organize help for certain events, activities or fundraisers (Room Mother)

I can help the Room Mother with events, activities or fundraisers, tell me what to do!

I like to make "cute" food, like shaped sandwiches, jello jigglers, or molded candies

At School:

Procure materials for a special project

Help monitor learning stations (centers)

Help with an art project

Read to students

Tutor students

Be a guest speaker

Help with special events and projects

Make copies

Change bulletin board displays

Lead out in Junior Achievement lessons

Inspect, repair and inventory classroom books

File

Take pictures on field trips

Inventory classroom materials

Help students in the school library/computer lab

Help monitor students during recess and/or lunch so the teacher can have a break/go to meeting

Talk to the class about:

Demonstrate to the class

At Home:

Make phone calls

Create a class scrapbook

Cut, punch, color or paste things

Collate information packets

Research topics on the Internet or at the local library

Sew projects

Bake

Label folders

Pray for you and the class

Personal Information:

Student's Name (nickname:)

Age Birth date //

Phone email

Best time to reach us: AM PM

AddressCityState Zip

Mother: occupation work phone

Hobbies:

Father: occupation work phone

Hobbies:

Married Divorced (child lives with mother / father)

Siblings:

age Attends AWS in 's room.

age Attends AWS in 's room.

age Attends AWS in 's room.

age Attends AWS in 's room.

 

After school my child will: 

 

walk home or to my office

Go to Kid's Camp (select: M T W Th F    

Ride home with:

 

In case of sickness or emergency during the school day, who should be contacted first?

 

1st name     relationshipphonecell

2nd name    relationshipphonecell

3rd name    relationshipphonecell

4th name    relationshipphonecell

 

Please list any special medical requirements, medications, or allergies:

 

 

 

Please answer the following about your child:

 

1. These are my child's strengths:

2. These are my child's weaknesses:

3. I would like to see my child grow in this area:

4. These are some concerns I have about this school year: 

5. These are my child's interests:

6. My child enjoys reading: yes no

7. This is about how much time my child watches TV each night hours min

8. My child does regular chores at home:  yes no

Comments:

    Please only submit one time!    Thank you so much for taking the time for these questions!

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