Reception Questionnaire

We expect children to have a certain degree of independence (appropriate to their age) before they begin Reception. This includes using the toilet independently and putting on and taking off their own coat and shoes. We recommend Velcro on both school shoes and trainers and lots of practice with buttons and zips before they begin school.

Name of Child: *

Date of Birth: *

Preschool Experience

Please state current nursery or nursery school (if applicable) *

How did your child settle into nursery/nursery school? *

Please give a brief description of your child’s experience at nursery/nursery school. *

What are your child’s interests? *

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Communication

Is your child able to express his/her needs verbally? *

Is your child able to speak clearly and audibly? *

How easy does your child find it to interact with others? *

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Additional Information

Does your child have an Educational Psychologist’s report? Yes/No If so, please provide us with all relevant documents. *

Does your child see any outside agency? (eg. speech therapist, occupational therapist) Yes/No If so, please state which agency and provide us with all relevant documents. *

Are there any learning difficulties in your family history?(eg. dyslexia) Yes/No If so, please state which difficulty. *

Have you had any concerns about your child from birth until now? Yes/No If so please give us full details *

Are there any family circumstances (eg. bereavement) that we should be aware of? Yes/No *

Is there anything else you would like us to know about your child? *

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Present Nursery Details

Name of present nursery: *

Headteacher's/ Nursery Manager's Name: *

Nursery Address: *

Telephone Number: *

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About US +

JOINING US +

NURSERY +

SCHOOL LIFE +

BEYOND THE CLASSROOM +

NEWS & EVENTS +

Preschool Experience

Communication

Additional Information

Present Nursery Details