Family Profile Form for New Students

To assist the Office of College, Counseling, and Support Services in facilitating your child's successful transition to NDCL

Parents of incoming freshmen or transfer students: Please take a few minutes to complete this form to help us more effectively serve your child and your family. The information you share with us is confidential and will be kept on file with your child's school counselor.

After you complete this form, you may click the "Submit" button or you may print out the form and return it to the school. If you would prefer to share these matters in person or by phone, please call the Counseling Office at (440) 286-6226.

* Student's LAST Name

* Student's FIRST Name

* School attended last year

Describe your goals, dreams, and aspirations for your child, especially as they may relate to any special talents, interests, or abilities. How can the school assist in realizing these goals and dreams?

Are there any family circumstances that affect your child that you would like to share with your child's school counselor?

Please share any special learning needs your child may have, including such items as:

1. Testing by a learning specialist or school psychologist; please include the reasons for the testing and a summary of the results; and

2. Information about any IEP, SP, SEGO, or 504 Plan developed at any time during grade school.

Does your child have any health needs such as prescribed medication for physical and/or psychological conditions?

If so, please describe the medication(s) and the condition(s) for which they have been prescribed.

Is the medication needed during the school day?

Yes

Not applicable

Is your child reluctant to take the medication?

Yes

Not applicable

Is your child currently being treated by a mental health professional? If so, please describe the areas of concern.

Please share any other information that will help us advocate for your child and your family.

Thank you for your help and participation.
We look forward to working with you over the next four years!

* Indicates Response Required