Childcare Program Needs

Child Care Program Needs
Name of Child
Date of Birth

MonthDayYear
***In order to best serve our families, it is requested that the following sections be filled out for every child enrolled in our centers. Section B is required for children ages six weeks through 33 months; recommended for children older than 33 months.***
A1) Please comment on any additional medical information or special need you would like Laker Prep Preschool and Early Childhood Center to be aware of, concerning this child
A2) What forms of communication work best for your family

Please rate 1-5 (#1 working best)
Email (Rate 1-5)
Text (Rate 1-5)
Paper (Rate 1-5)
Phone Call (Rate 1-5)
In Person (Rate 1-5)
A3) My child has interests and likes in the following areas
A4) What language is mostly spoken in your home
A5) Please share any additional information, related to your child’s cultural identity that you would like us to know
B) Please note childcare program needs for your child in regards to
Eating
Sleeping
Toileting
Communicating
Calming Method
C) Anticipated Weekly Routine (as typical as you think your week would go)!

Laker Prep locations are open year around, with exception of some scheduled holidays and training/maintenance days. Operation hours will be 7:30a.m. to 5:15 p.m.
Monday

Drop Off

AM/PM Option

Until
until
Pick Up

AM/PM Option
Tuesday

Drop Off

AM/PM Option

Until
until
Pick Up

AM/PM Option
Wednesday

Drop Off

AM/PM Option

Until
until
Pick up

AM/PM Option
Thursday

Drop Off

AM/PM Option

Until
until
Pick Up

AM/PM Option
Friday

Drop Off

AM/PM Option

Until
until
Pick Up

AM/PM Option
Should be Empty:

Child Care Program Needs