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Name Date of Birth ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ABOUT YOUR CHILD What language(s) are spoken in your home?_____________________________________________________________________________________________您的孩子最常使用哪种语言进行交流？_________________________________________________________________________ I would describe my child in this way: _______________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Has your child had以前在团体育儿或学龄前经验？Yes No Please describe: ________________________________________________________________________________________________________ _________________________________________________________________________________________________________
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