Applicant's Name
First Name
Last Name
Applying for class/grade
1. Tell us about your son or daughter. Include please their current strengths and challenges.
This may include a brief history of early childhood events, sibling relationships, and other details as age appropriate.
2. Share please your parenting strengths and challenges, and areas you would like support with developing.
3. What is your son's or daughter's daily rhythm or routine?
For example: What time does S/he go to bed? What time does s/he awaken? Does s/he have difficulty sleeping through the night?
4. Does your son or daughter have dietary limitations, eating challenges, or allergies?
5. Please describe any circumstances in your son's or daughter's home, family, school, or environment, that may have had supportive or negative effects on his or her personal and school life.
6. Has your son or daughter ever had any serious physical condition, iillness or injuries? If so, please describe.
Please indicate the year these occurred.
7. Please describe any prior special needs of your son or daughter.
For example, have there been learning difficulties, emotional or behavioral difficulties, previous counseling?
8. In what sort of extra-curricular activities does your son or daughter participate? What does your child do in his or her free time? How much television does s/he watch? How much time with computer or video games?
9. Does your child enjoy or have challenges with peer interaction ? What strategies do you use to create peaceful and pleasant peer interaction ? What would you like FSMN to assist with in peer relationships ?
10. Which languages are spoken in your home? Does your son/daughter have communication challenges? What strategies do you use to help your child with communication, if it is needed?
11. What are your expectations for our school?
Additional Comments
Please also include any information pertinent to your child receiving special services such as speech therapy, occupational therapy, physical therapy, etc. A full report from the service provider(s) must be forwarded to the Forest School of Minnesota prior to acceptance. Full disclosure of such services must be provided prior to consideration for admission.