St. James Parents Questionnaire

Parents or Guardians: Your comments about your child are important to us. Please complete the following questionnaire. All information will be regarded as confidential.

Applicant's Name
Name of person(s) completing this form
relationship to Applicant
Applying to Grade
What factors contributed to the decision to apply to St. James?
What words or phrases come to mind when describing your child?
Please comment on what your consider to be your child's strengths.
What do you hope your child will gain by attending St. James?
What are your child's activities and interests?
Has your chuld ever has an educational, psychological, or neurological evaluation? If so, when and by whom? is your child on medication? If so, what kind? is your child currently in speech or physical therapy? If so, what kind?
Is there any health situation that might interfere with the normal performance of regular St. James classes or physical education activities? If yes, please explain.
If applying for pre-kindergarten or kindergarten: is your child potty trained?	Yes No
Parent or Guardian Signature
Date

Please answer the simple math question below to submit the form.

2 + 2 =

Applying to St. James

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