Trinity Day School and Kindergarten
(established 1958)

Information, Please

Trinity’s goal is to help each child learn in a positive school environment. This information allows us to help build your child’s self-confidence and independence.

1. Child’s Name (nickname):__________________

2. Date of Birth: ___/__/___

3. Phone:___________

4. What skills does your child have?

(Circle all that apply)

Shapes: l n D _ © « u _

Counts to: ______________ (in order)

Can say his/her full name:

Colors:

Has experience with crayons:

Has experience with scissors:

Ties shoes

Buttons/zips own clothing:

Talks in sentences:

Sings songs:

Plays games:

Combs hair:

Is Potty Trained:

Knows parent(s) name(s):

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Mother Father

5. Does your child have any health concerns?

(circle yes or no)
Speech or Hearing

Health or allergies

Yes No

Yes No

(Please explain on the back of this form)

6. Are both parents in the home? Yes No

7. Please list names and ages of child’s sisters and brothers:
        ____________________________________________

8. Is your child afraid of anything? Yes No

If so, what (briefly explain)                                  

9. What are your expectations from Trinity’s program for your child? (Use back to answer)

Thank You!

*This will be an exciting year! We look forward to being with your child and working with you.*

Mrs. Delores Bush, Director
(505) 624-2305