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Family Information Notebook (FIN) - Vanderbilt Kennedy Center

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CHILD’S NAME: DATE OF BIRTH:<br />

38<br />

SCHOOLS ATTENDED<br />

This form will help you keep track of school information on your child each year. Begin with the first program your<br />

child attended and enter the new one each time your child changes schools or grades.<br />

Name of Program / School:<br />

Name of School District:<br />

City: State:<br />

Name of Teacher: Grade or Child’s Age:<br />

Check One: Fall Spring Summer Year:<br />

Other school services (e.g. occupational therapist (OT), physical therapist (PT), remedial reading,<br />

speech, etc.):<br />

Name of Teacher / Therapist: Type of Class / Frequency of Attendance<br />

Reason for leaving program / school:<br />

Name of Program / School:<br />

Name of School District:<br />

City: State:<br />

Name of Teacher: Grade or Child’s Age:<br />

Check One: Fall Spring Summer Year:<br />

Other school services (e.g. occupational therapist (OT), physical therapist (PT), remedial reading,<br />

speech, etc.):<br />

Name of Teacher / Therapist: Type of Class / Frequency of Attendance<br />

Reason for leaving program / school:<br />

Early Intervention Programs, Nursery Schools, Preschools,<br />

Day Care, Public Schools, Special Schools<br />

In-home Programs<br />

© Junior League <strong>Family</strong> Resource <strong>Center</strong> 2005

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