Individualized Family Communication Plans

Tell Me A Little Bit About Your Child

All information will be kept confidential.

Your Name: Alan Xun_______________________________________________________________

Your Child’s Name: Annie Xun________________________________________________________

Nicknames: None__________________________________________________________________

Does your child have allergies or any other health conditions we should be aware of? No.______________________________________________________________________________ _________________________________________________________________________________

What is the most important thing I should know about your child?

She doesn’t like to sit and do nothing.__________________________________________________

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Briefly describe your child’s personality.

Very friendly. Sometimes bossy. Likes to play with other children.____________________________

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What are some of your child’s favorite activities?

She likes to draw pictures and look at books with pictures. She like to go to the park and play on__ swings.___________________________________________________________________________ _________________________________________________________________________________

How will your child get home from school (bus, carpool, other)? Bus__________________________

Is there anyone else who will regularly pick up your child from school?

Yes, grandma or grandpa.____________________________________________________________ _________________________________________________________________________________

Please share any other information that you think will be important for me to know.

My wife and I work long hours and are not able to spend lot of time with Annie. My parents take care of her. They don’t speak a lot of English. My son speaks English to Annie sometimes.________ _________________________________________________________________________________

Tell Me A Little Bit About You and Your Family

Do you speak another language at home? If so, which one?

Chinese.__________________________________________________________________________

Do you read to your child? How often?

No, her brother reads to her sometimes.________________________________________________

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Who else lives at your house (grandparents, siblings, pets, etc.)?

Grandma, grandpa, uncle, big brother__________________________________________________

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What is your preferred method of communication (email, phone call, note, meeting, etc.)?

Email or note._____________________________________________________________________

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How would you like to be involved in our classroom? Please check all that apply.

___ Cut out materials at home

___ Help at class parties/events

___ Help make art projects and crafts

___ Attend field trips

___ Other ________________________________________________________________

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