Nursery Questionnaire

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ID *
N/A
Date-Time
N/A

MM/dd/yyyy HH:MM AM/PM
SF.AccountName *
N/A
Family & Child Info
Child 1 Name *
N/A

First and Last
Child 1 Birthdate *
N/A

MM/dd/yyyy
Child 1 Current School
N/A
Home Address
N/A

Street Address
Address Line 2 City State/Region/Province
Postal / Zip Code

Country
Are you considering moving from this address
N/A

Yes
No
Maybe
Primary Email *
N/A

This is the main email we will use for all Smart City Communications.
Parents
Parent 1 Name *
N/A

Title. First Name Last Name
Profession
N/A
Company
N/A
Title
N/A
Parent 1 Email
N/A
Parent 1 Cell
N/A
Work Address
N/A

Street Address
Address Line 2 City State/Region/Province
Postal / Zip Code

Country
Parent 2 Name *
N/A

Title. First Name Last Name
Profession
N/A
Company
N/A
Title
N/A
Parent 2 Email
N/A
Parent 2 Cell
N/A
Work Address
N/A

Street Address
Address Line 2 City State/Region/Province
Postal / Zip Code

Country
Are you looking to apply another child? *
N/A

	Preference
Within 10 blocks
Within 1 mile

	Preference
Single Sex
Coed

	Preference
Low pressure, nurturing
Pre-academics focus
Pre-reading instruction
Pre-math instruction
Curriculum geared to the above average child
High expectations and standards
Activities are initiated by the student (child-centered)
Activities are initiated by the teacher (traditional)
Montessori philosophy incorporated
Mixed-age or flexible class grouping
Reggio Emilia philosophy incorporated
Multi-cultural curriculum (integrated study of cultures)
Extra support services available
Structured curriculum
Students tracked for top private schools
Strong art program
Strong physical education program
Strong music program

	Preference
Strong parental involvement
A concern for social welfare is part of the culture
Wealthy community
Families involved in NY society
Strong business community
Strong community of artists
Diverse parent body
High proportion of stay at home parents
High proportion of both parents working
Class conscious
Parents have an informal tone and manner
Parents have a formal tone and manner

	Preference
Comparatively small
Comparatively large
Continues on from nursery school

Additional Questions
Please describe your child
N/A
Does your child have any special needs that we should be aware of?
N/A
What is most important to you in the school you select for your child?
N/A
Is there anything about nursery school admissions that particularly concerns you?
N/A
Is there anything else you can tell us that would help us in any way?
N/A
Have you applied to any nursery schools in the past?
-- No Fields Available --
- School Name
- Outcome
Add another Add another
- School Name
  N/A
- Outcome
  N/A
- School Name
  N/A
- Outcome
  N/A
Are you interested in applying for financial aid?
N/A

Yes
No
If applying for aid, what is your annual household income USD
N/A
How did you hear about our services?
N/A
Who Referred You?
N/A

Family & Child Info