ORIENTATION INFORMATION
Child's Full Name
*
Date of birth
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Preferred Name
Days of attendance
*
Monday
Tuesday
Wednesday
Thursday
Friday
Likes
*
Dislikes
*
My Favourite Song is
*
My Favourite book is
*
My Favourite toy is
*
Goals
*
FAMILY INFORMATION
I live with
*
At home the language we speak is
*
Our Cultural background is
*
We celebrate
*
Our cultural traditions include
Please list the skills, talents, interest and culture that you and your family (not forgetting grandparents) are able to share with the service.
Eating Habits
I have a food allergy/intolerance/dietary requirement
*
YES
NO
Please explain the allergy
Favourite food
*
Food I don't like
*
TOILETING HABITS
I AM
*
Toilet trained
Toilet training
Nappies/Pull-ups
SLEEPING HABITS
I like to have a
Sleep
Rest during the day (include when and how long)
My sleep/ Rest time routine includes
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