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scope of work template
							                                   CAPE Children’s Services
                                    Take Home Curriculum
                                     Homework Activities
                                                  Site and
Child’s Name ___________________________________ Classroom _____________________________
Motor: Age 3-4
Activity #1
  Make a puzzle by cutting a photo or magazine picture into 3 or 4 shapes. Keep the shapes of
  the pieces simple, such as 2 squares and a rectangle. Hand child one shape at a time. If
  necessary, point to the place it goes into and guide his hand.
Time Spent: __________ minutes      Parent signature: _________________________________
Motor: Age 3-4
Activity #2
  Using a shape box, remove one shape at a time and give it to child to replace. If necessary,
  show her where to place each shape by pointing to the correct hole. Start with simple shapes,
  such as square, circle, and triangle; later you can add the more complex shapes. A shape box
  which makes noise when the shape goes through might be especially motivating.
Time Spent: _________minutes       Parent signature: _________________________________
Motor: Age 3-4
Activity #3
  Using a form board puzzle, have child trace around the empty spaces in the puzzle with his
  finger and then find the piece that looks and feels like that shape.

Time Spent: _________ minutes       Parent signature: _________________________
Motor: Age 3-4
Activity #4
  Place the shapes above or next to the correct openings and then have the child replace them.
Time Spent: __________ minutes      Parent signature: _________________________________
Motor: Age 3-4
Activity #5
  Use a large wooden puzzle with 3 forms; a circle, square, and triangle. Place knobs on each
  puzzle piece so they are easily grasped. Remove the shapes (or let child remove them) and
  give them to the child one at a time for her to replace.
 Time Spent: __________ minutes     Parent signature: _________________________________
Other Activities:
1.____________________________________________________________________________

Time Spent: __________ minutes Parent signature: ________________________________
2.____________________________________________________________________________

Time Spent: __________ minutes      Parent signature__________________________________

Teacher signature _____________________________________________Total minutes____________


Date signed by teacher____________________

						
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