3 years ago

preschool enrollment application

preschool enrollment application

John E. McCormac,

John E. McCormac, MayorWOODBRIDGE COMMUNITY CENTER600 Main Street, Woodbridge, NJ 07095Phone: 732-596-4170 Fax: 732-596-4187CHILD’S PERSONAL HISTORYChild’s Name ____________________________________________________________________________1. Name and age of other children in the family _______________________________________________________________________________________________________________________________________2. Other close relationships in the household ___________________________________________________3. Previous group experiences _______________________________________________________________4. Does he or she play well with others? _______________________________________________________5. Does he or she play well by him/herself? ____________________________________________________6. List any and all allergies your child has ______________________________________________________7. List any fears your child has ______________________________________________________________8. List your child’s daily sleeping schedule: AM wake-up _________ PM bedtime Nap _____________9. Does your child sleep in a bed or a crib? _____________________________________________________10. Is your child sleeping through the night? ____________________________________________________11. What does your child find soothing or comforting? __________________________________________________________________________________________________________________________________12. Please list any unusual habits your child has _______________________________________________________________________________________________________________________________________13. Does your child use a pacifier? _ ______________ If so, when? ______________________________14. Is your child using a cup, bottle, or both? ___________________________________________________15. Does your child primarily drink whole milk, breast milk, or formula? ______________________________16. How many ounces per feeding? ___________________________________________________________17. What times of day does your child take a bottle? _____________________________________________18. Is your child now on baby food or table food? ________________________________________________19. Please list your child’s food preferences ____________________________________________________20. Is your child eating independently? ________________________________________________________21. How does your child spend his/her waking hours? __________________________________________________________________________________________________________________________________22. Has your child started potty training? If yes, describe his/her routine, including vocabulary used.______________________________________________________________________________________23. Does your child have a regular elimination schedule? __________________________________________24. Any additional comments or concerns? _____________________________________________________25. Does your child ask to use the bathroom? ___________________________________________________26. Can your child use the bathroom independently? _____________________________________________27. Can your child dress him/herself? _________________________________________________________28. Is your child able to verbally communicate his or her needs? ____________________________________29. Is your child comfortable leaving a parent? __________________________________________________30. Does your child react well to changes in routine? _____________________________________________31. Please list what you feel to be your child’s strongest qualities: _________________________________________________________________________________________________________________________32. Please list the areas you think your child needs to work on: ___________________________________________________________________________________________________________________________33. Any additional comments or concerns: ___________________________________________________________________________________________________________________________________________6

John E. McCormac, MayorWOODBRIDGE COMMUNITY CENTER600 Main Street, Woodbridge, NJ 07095Phone: 732-596-4170 Fax: 732-596-4187Child’s name: ________________________________Parent Signature:________________________________EXPULSION POLICYUnfortunately, there are sometimes reasons we have to expel a child from our program either on a short term or permanent basis.We want you to know that we will do everything possible to work with the family of the child(ren) in order to prevent this policy frombeing enforced. The following are reasons we may have to terminate or suspend a child from this Center:PARENTAL/GUARDIAN’S ACTIONS FOR CHILD’S EXPULSION (INCLUDING, BUT NOT LIMITED TO ANY ADULT RESPONSIBLE FORDROPPING OFF OR PICKING YOUR CHILD) Failure to pay, habitual lateness in payments Habitual tardiness when picking up your child Physical or verbal abuse to staff Sexual harassment of staff Failure to complete required forms including child’s immunization forms Failure or refusal to abide by Center policies and proceduresCHILD’S ACTIONS FOR EXPULSION Inability of child to adjust after a reasonable amount of time Uncontrollable tantrums/angry outbursts Ongoing physical or verbal abuse to staff or children Excessive bitingPROACTIVE ACTIONS THAT WILL BE TAKEN IN ORDER TO PREVENT EXPULSION Staff will try to redirect child from negative behavior Staff will re-assess classroom environment, appropriateness of activities, supervision Staff will always use positive methods and language when disciplining children. Staff will praise appropriate behaviors Staff will consistently apply consequences for rules Child will be given verbal warnings A brief time-out will be given so child can regain control Child may lose certain privileges Child’s disruptive behavior will be documented and maintained in confidentiality Parent/guardian will be notified verbally Parent/guardian will be given written copies of behaviors that might lead to expulsion The director, classroom staff, and parent/guardian will have a conference to discuss how to promote positive behaviors The parent will be given literature or other resources regarding methods of improving behavior Recommendation of evaluation by professional consultation on premises Recommendation of evaluation by local school district child study teamSCHEDULE OF EXPULSIONIf after the remedial actions above have not worked, the child’s parent/guardian will be advised verbally and in writing about thechild’s or parent’s behavior warranting an expulsion. An expulsion action is meant to be a period of time so that theparent/guardian may work on the child’s behavior or to come to an agreement with the Center.The parent/guardian will be informed regarding the length of the expulsion periodThe parent/guardian will be informed about the expected behavioral changes required in order for the child or parent toreturn to the CenterThe parent/guardian will be given a specific expulsion date that allows the parent an adequate amount of time to seekalternate child care (approximately one to two weeks depending on risk to other children’s or staff welfare or safety)Failure of the child/parent to satisfy the terms of the plan may result in permanent expulsion from the Center7

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