2008Children’s Bio Card Questionnaire
FOR 5 YEAR OLDS & UNDER
PART A :
Child’s Complete Name ______Child’s Age ______
(Please take a moment to double check the spelling, will be printed as written on image.)
Child’s Birthday (dd/mm/yy) ______Current Grade Level ______
(Complete Birthday is required, please double check for accuracy.)
Location of current home (ex: Plant City, South Tampa, etc.) ______
(Please be as specific as possible.)
Currently at a Group Home? Y or N If yes, Name of Group Home ______
Child’s School ______
Is this child part of a sibling group? Y or N
Please list the names and ages of the siblings: ______
______
This child WOULD _____ or WOULD NOT _____ adopt separately from his/her siblings.
Does this child have special needs? Y or N If yes, please explain: ______
______
______
PART A : Continued
2008Children’s Bio Card Questionnaire
FOR 5 YEAR OLDS & UNDER
Please answer the following questions as fully as possible. Focusing on the positive aspects of the child and identifying qualities that make him/her a unique individual will be a wonderful help in creating a dynamic and engaging biography.
1.) What are five of this child’s best characteristics?
______
______
2.) What does this child excel at above all else? Please cite academic and social examples. (Example: math and reading; telling the truth, helping others, etc.)
______
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3.) In social situations, how does this child behave? (example: he/she is outgoing and friendly; shy and withdrawn; the entertainer and prankster, loving, etc.)
______
4.) What makes this child unique?
______
______
5.) This child is loved by others because ______
______
6.) She/he should be proud of her/himself, because ______
______
7.) This child would make an excellent daughter/son because ______
______
Continue to next page…
2008Children’s Bio Card Questionnaire
FOR 5 YEAR OLDS & UNDER
PART B:Please fill out with child, by asking the questions and transcribing.
1. What is your favorite animal and why? ______
2. What is your favorite game? ______
3. What is your favorite place? ______
4. List three things you love about yourself. (Example: funny, athletic, smart, etc.)
______
5. What would you like to be when you grow up? ______
______
6. What kind of music do you like? ______
7. What are your three favorite things to do? (Example: play outside, draw, play an instrument, etc.)
______
8. Do you like to play sports? If so, which ones? ______
9. What three things make you most happy? ______
Fill in the blank:
On a rainy day, I like to ______.
On a sunny day, I like to ______.
I’m very special and unique because ______.
The one thing I would like people to know about me is ______.
One of the most important things to me is ______.
Thanks for your time! Love, the HeartGalleryTampaBay