Question 1

Authorization for Release Form

Accepted Answer

Primary School Background Information

LANGUAGE EXPERIENCE QUESTIONNAIRE

Student’s Name:

Date of Birth:

Native Language:

Social Information

How does your child feel about moving to Rio de Janeiro and beginning school at RIS (e.g., excited, anxious etc.) ?

In general, how does your child adjust to new situations (e.g., easily, enthusiastically, cautiously, reluctantly, etc.) ?

Language Information

Briefly describe your child’s first experience with language:

• When did your child say his/her first words?

• In which language?

• Were there any concerns about early language development (eg., late to start talking, distorting sounds, problems being understood, et.)?

Is your child a native English speaker?

Yes

No

If No, what experience does your child have with the English Language?

What is your impression of your child’s general level of language skill?

+ (Strong Ability) X (Growing Proficiency) – (Weak Ability)

English | Listening:

Reading:

Speaking:

Writing:

Native Language | Listening:

Reading:

Speaking:

Writing:

To what extent will you be able to help your child with homework in English?

Not at all

Very little

Some

A lot

To what extent will you be able to help your child with homework in English?

Birth and Early Childhood Information

Were there any illnesses, accidents, or complications associated with your child’s birth or prenatal development?

Yes

No

Please comment:

No Did your child experience any significant health, learning or other difculties during his/her first five years of live?

Yes

No

Please comment:

Has your child experienced difficulties with fine or gross motor development which limit his/her activity?

Yes

No

Please comment:

IN SCHOOL

Yes

No

OUT OF SCHOOL

Yes

No

NAMES/PHONE NUMBERS AND/OR EMAIL

IN SCHOOL

Yes

No

OUT OF SCHOOL

Yes

No

NAMES/PHONE NUMBERS AND/OR EMAIL

IN SCHOOL

Yes

No

OUT OF SCHOOL

Yes

No

NAMES/PHONE NUMBERS AND/OR EMAIL

IN SCHOOL

Yes

No

OUT OF SCHOOL

Yes

No

NAMES/PHONE NUMBERS AND/OR EMAIL

IN SCHOOL

Yes

No

OUT OF SCHOOL

Yes

No

NAMES/PHONE NUMBERS AND/OR EMAIL

IN SCHOOL

Yes

No

OUT OF SCHOOL

Yes

No

NAMES/PHONE NUMBERS AND/OR EMAIL

IN SCHOOL

Yes

No

OUT OF SCHOOL

Yes

No

NAMES/PHONE NUMBERS AND/OR EMAIL

Does RIS have permission to contact these specialists?

Yes

No

Se você é humano, deixe este campo em branco.

Question 2

Primary School Background Information

Accepted Answer

URMES – Medical Information / Dados Médicos

Name/Nome:

DOB/Data De Nascimento:

Weight/Peso:

Is the student allergic to something? If yes, please explain / O aluno é alérgico? Se sim, especifique, por favor:

Yes/Sim

No/Não

Medications/Medicações:

Other/Outros:

Medication: If necessary, the school may dispense the following medication to my child / Medicamentos: Se necessário, a escolar pode medicar os seguintes remédios para meu filho(a):

Fever/Febre:

In case of small accidents, do you have any restrictions? / Em caso de pequenos acidentes, você possui alguma restrição?

Is the student taking any medications regularly? Explain / O aluno faz uso regular de algum medicamento? Especifique:

In the past, has the student experienced seizures or fainting? / O aluno já apresentou convulsão ou desmaio?

Yes/Sim

No/Não

If so, when? / Se sim, quando?

Se você é humano, deixe este campo em branco.

Question 3

Request more information

Accepted Answer

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        <span class="frm_required" aria-hidden="true">*</span>
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    <label for="field_6fikj" id="field_6fikj_label" class="frm_primary_label">Parent´s cell number
        <span class="frm_required" aria-hidden="true">*</span>
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    <label for="field_ftuys" id="field_ftuys_label" class="frm_primary_label">Parent´s e-mail
        <span class="frm_required" aria-hidden="true">*</span>
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Question 4

RIS Parent Pre-Registration Questionnaire

Accepted Answer

RIS Parent Pre-Registration Questionnaire

EARLY CHILDHOOD PROGRAM

Dear Parents and Guardians,

We are delighted that you are interested in enrolling your child in the early childhood program at RIS.
The purpose os this questionnaire is to obtain information about your child’s physical, social, academic and emotional development prior to registration. The information you give will be used in the screening and placement process.

PreSchool is a pre-kindergarten program. The program runs from 8:00 am to 3:20 pm. A child must be 4 years old by September 30 to be accepted into this program.

Name of child:

Date of birth:

Completed by:

Relation to child:

Personality

Please give three words that best describe your child’s personality:

Please tell us your child’s interests . How does he/she spend free time?

Please describe any fears or anxieties your child may have.

Developmental History

Language

If your child has previously attended school, how much instructional time each day was conducted in English?

Entirely in English

50% English Less than

50% English

No English instruction

Motor

Have there been concern about your child’s motor development?

Yes

No

E.g walking late, balance or coordination problems, difculty holding pencil or with writing or handling small objects.

Please give details:

Family Information

If are new to Rio De Janeiro, please comment on any changes for your family associated with the move (e.g. change in work routine for either parent, type of present living accommodation).

How does your child show afection?

Describe your child’s separation behavior when you leave him/her with other caregivers.

What things do you do to ease any separation problems?

Who are the main people that are responsible for establishing behavioral expectations and consequences for your child (mother, father, domestic help, others)? Please explain.

What form of discipline do you use at home and how does your child respond to discipline?

Sleeping habits

Does your child nap in the day? If so when and how long?

How many hours does your child normally sleeps at night?

What is your child’s usual bedtime on weeknights?

Describe your child’s bedtime routine.:

Eating habits

Is your child able to feed him/herself independently? Explain

What are your child’s preferred foods?

Se você é humano, deixe este campo em branco.

Question 5

URMES - Medical Information / Dados Médicos

Accepted Answer

URMES – Medical Information / Dados Médicos

Name/Nome:

DOB/Data De Nascimento:

Weight/Peso:

Is the student allergic to something? If yes, please explain / O aluno é alérgico? Se sim, especifique, por favor:

Yes/Sim

No/Não

Medications/Medicações:

Other/Outros:

Medication: If necessary, the school may dispense the following medication to my child / Medicamentos: Se necessário, a escolar pode medicar os seguintes remédios para meu filho(a):

Fever/Febre:

In case of small accidents, do you have any restrictions? / Em caso de pequenos acidentes, você possui alguma restrição?

Is the student taking any medications regularly? Explain / O aluno faz uso regular de algum medicamento? Especifique:

In the past, has the student experienced seizures or fainting? / O aluno já apresentou convulsão ou desmaio?

Yes/Sim

No/Não

If so, when? / Se sim, quando?

Se você é humano, deixe este campo em branco.

Formularios

Primary School Background Information

LANGUAGE EXPERIENCE QUESTIONNAIRE

Social Information

Language Information

Birth and Early Childhood Information

School History

Has your child received any of the following services? Please Check:

URMES – Medical Information / Dados Médicos

Medication: If necessary, the school may dispense the following medication to my child / Medicamentos: Se necessário, a escolar pode medicar os seguintes remédios para meu filho(a):

Request more information

RIS Parent Pre-Registration Questionnaire

EARLY CHILDHOOD PROGRAM

Personality

Developmental History

Motor

Social Development

Put an “X” in the box that best describes your child.

Family Information

Routines

Sleeping habits

Eating habits

URMES – Medical Information / Dados Médicos

Medication: If necessary, the school may dispense the following medication to my child / Medicamentos: Se necessário, a escolar pode medicar os seguintes remédios para meu filho(a):

ABOUT RIS

ACADEMICS

ADMISSIONS

COMMUNITY