Upper Elementary Admissions – Family Questionnaire For all families considering Parkside for the next school year, please complete and submit this questionnaire before your required classroom observation and administration meeting. Child's Name:* First Last Date of Birth:* MM DD YYYYUpload Child's Picture*Upload a recent picture of your child (family photos are accepted as well).Parents' Names and Occupations:*Preferred Email Address* Do both parents live in the same house?*YesNoNames and ages of siblings:*What is your child's first language?*What other languages are spoken in the home?*School BackgroundPlease list the name and dates of attendance of all schools that your child has attended and include your reason for leaving.Name of School:*Name of School:Name of School:At what age did your child begin to read?*What books is your child currently reading?*Does your child have mastery of addition and multiplication tables?*How would you describe your child's grasp of mathematics in general?*What would you consider to be your child's academic strengths and challenges?*Why are you seeking Parkside's Upper Elementary Program?*How did you find out about Parkside?*Online SearchSchool Street SignPublicationParkside Family (Current or Alumni)OtherWhat is your family and child's history with prompt and consistant attendance?*Do you plan to have your child out of school for travel or other reasons?*UPE has weekly work assignments with due dates. How does your child handle time management?*Is your child willing to work in content areas that may be challenging for them?*Homework is a requirement in the UPE program. It can be from one and a half hours to upwards of three hours a week depending on the child and home environment. Has your child had homework before, and if so, how well did they cope?*Describe your child's screen time (TV, video, computer, iPad, etc) - when and how long?*What would you consider to be your child's social strengths and challenges?*What three words best describe your child?*What are your child's interests and favorite activities?*Has your child been professionally evaluated (speech, SI, OT, etc)? Have they received or are they receiving outside tutoring or therapy?*YesNoIf yes, please explain.Anything significant in your child's medical history we should know about?*What are your questions about the program or Parkside in general?*Please list anything else you would like to tell us about your child.NameThis field is for validation purposes and should be left unchanged.