Child Daycare Profile

Child Daycare Profile
Child Name
Parent Name
YYYY dash MM dash DD
Does your child speak English?
Does one parent speak English?
Please select how active your child is
Has your child attended daycare preschool/afterschool before?
If yes, for how long did your child attend preschool/afterschool?
Does your child need help with the following? (check any that apply)
Does your child require additional support (i.e. autism, ADHD, etc)?
If yes, check any that apply
Does your child currently have an Educational Assistant (EA) while attending school?
What does your child like to do? (i.e. :look at books, listen to music, play with other children, play outdoors/indoors, toys, climb/run/jump, paint, computer, imaginative play/dress-up)
This field is for validation purposes and should be left unchanged.


Play, Have Fun, Enjoy Life!

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