54-month Assessment


  • Dear Parents,

    Please help us get to know your child by filling out this form. All the information will be confidential. We will use what you tell us as we begin to get to know your child and plan ways to meet his/her needs and to help him/her develop. Please return it to school as soon as possible.

    Thanks so much!

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  • It is our goal to encourage a sense of belongingness, promote an appreciation of others and enrich children’s experiences by integrating into our curriculum activities and information that reflect our individual children’s background.  One way we can do this is by learning about each child’s family background, celebrated holidays, and traditions. Please take a few minutes to share with us your special family days or activities and how they are carried out in your home.

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  • Person filling out Questionnaire

  • Program Information

  • Important Points to Remember:

    • Try each activity with your child before marking a response.
    • Make completing this questionnaire a game that is fun for you and your child.
    • Make sure your child is not tired or hungry.
    • Please return this questionnaire by ________________________
    • Gross Motors

    • Fine Motor

    • Problem Solving

    • Personal Social