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Pre-Enrollment Questionaire
You
do not need to
submit this form unless you are also submitting the enrollment packet.
Parent's Name:
(Required)
Child's Name:
(Required)
Child's DOB
(Required)
MM slash DD slash YYYY
Thanks for taking the time to complete our Questionaire. This will better enable us to determine if your child will benefit from our program. It will also help us to determine if we are equipt for your childs specific needs. Your responses will not be the sole determining factor in the enrollement of your child, but it will enable us to discuss issues and concerns prior to enrollment, avoiding misunderstandings in the future.
1. Has your child attend Daycare in the past 6 months:
(Required)
Yes
No
Not Specified
2. Is your child completely potty trained?
(Required)
Yes
No
Not Specified
3. If response to #2 is no, has potty training started?
(Required)
Yes
No
Not Specified
4. If the response to #3 is no, please emplain
(Required)
5. Is your child currently in school?
(Required)
Yes
No
Not Specified
6. Does your child have any medical issues that we may need to be aware of?
(Required)
Yes
No
Not Specified
7. If response to #6 was yes please explain.
(Required)
8. Is your child on any ongoing medications for the issue listed above?
(Required)
Yes
No
Not Specified
9. Has your child ever been diagnosed with ADD, ADHD or any related diagnosis?
(Required)
Yes
No
Not Specified
10. If the response to #9 was yes, what was his/her diagnosis?
(Required)
11. Is your child on any medications for the diagnosis listed above?
(Required)
Yes
No
Not Specified
12. Which medications does your child take and will the center need to administer them?
(Required)
Yes
No
Not Specified
Mediations:
(Required)
13. If your child is in school, are they on any specific plans at his/her school.
(Required)
Yes
No
Not Specified
14. If your child is enrolled, would you be willing to share his/her plan so that we can better assist your child with his/her needs?
(Required)
Yes
No
Not Specified
15. Is there anything that you feel we should know in order to better care your child?
(Required)
Yes
No
Not Specified
Comments
(Required)
Alphabet Zone Kingwood
(281) 747-7456
azonekingwood@gmail.com
1418 North Park Dr. Ste B
Kingwood, TX 77339
6:00 am - 7:00 pm (Mon - Fri)
Alphabet Zone New Caney
346-347-9289
alphazonenc@gmail.com
18934 East Industrial Pkwy
New Caney, TX 77357
6:00 am - 7:00 pm (Mon - Fri)
Home
Programs
Infants
Toddlers
Preschool
Schoolers
About Us
About Us
Careers
Tuition Support
Why Choose Us
Careers
Locations
Alphabet Zone Kingwood
Alphabet Zone New Caney
Parent Corner
Contact Us