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Preschool
SPARK Questionnaire 2025-26
First Name
Last Name
Email
Child First Name
Child Last Name
Which SPARK program do you need? Check one
SPARK Jr (nursery)
SPARK (K-5th grade)
SPARK+ (6-12 grade)
Which service do you plan to attend? Please keep in mind that the one-on-one buddy program is only available during the 10:30 service.
1st service
2nd service
Explain your child's diagnosis, medical conditions, disability
Does your child need bathroom help? If yes, please explain
Communication Needs
Communicates fully
Limited
Nonverbal
Communication Device
Sign Language
What are your child's interests?
What are your child's points of frustration or resistance? How can we best assist during these times?
What are some goals you would have? Examples - sit through story time, interact with peers, engage by answering questions, participate in activities
Please include any other information that would be helpful to know about your child.
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