Early Intervention PreK (EI-PreK) and/or Junior Kindergarten (JK) with BGSD for the 2024-2025 school year.

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Early Intervention PreK (EI-PreK) and/or Junior Kindergarten (JK) with BGSD for the 2024-2025 school year.

Thank you for your interest in the Early Intervention PreK and/or Junior Kindergarten programs offered by the Black Gold School Division for the 2024-25 school year. These programs serve as early intervention sites designed to assist children experiencing delays in one or more areas of development and/or those with English as an additional language. To determine if your child meets eligibility criteria for our programs, please respond to the following questions. Based on the information provided, we will guide you through the next steps. Upon completion of this online intake, a member of our staff will contact you within 3-4 business days in response to your submitted form

*Note: There is a yearly material enhancement fee of $60.00 for 3 year old students and $80.00 for 4 year old students.

Please answer the below initial intake questions:

Email *

Child First and Last Name *

Address (house address including postal code) *

Town or Municipality *

Parent/Guardian First and Last Name *

Parent/Guardian Primary Phone number *

Parent/Guardian Secondary Phone number *

Parent/Guardian's Email Address for all communication (please ensure you check this email address often for regular communication) *

Child Date of Birth *

YYYY

What area(s) of concern do you have about your child's development? *

English as an Additional Language (another language is spoken in the home)

Speech/Language (ie. difficulty following directions, communicating needs, pronunciation)

Motor Skills and Self Care (ie. toilet training, feeding, dressing, eye-hand coordination, balance, participation in play)

Deaf/Hard of Hearing

Blind/Low Vision

Social/Emotional (ie. turn taking, anxiety, aggression, tantrums, social skills, changes in routines/transitions)

Medical Diagnosis (ie. Down’s Syndrome, ASD, Cerebral Palsy )

Required

Supporting agencies or health professionals currently involved if applicable (ie. AHS, Glenrose, mental health agency, SLP, psychologist, psychiatrist, Robin Hood, EIP)

Please indicate if you have any current reports or documentation about your child's needs. If yes, please email to: Rebecca.Aiken@blackgold.ca and Mary.Vasek@blackgold.ca *

yes

Required

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