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Musson Elementary Kindergarten Registration
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Student Information
Please complete the following information for each child you will be registering. This form will be used during the placement process to help us create balanced classrooms.
Student Name (First and last)
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Your answer
Gender
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Male
Female
My child prefers to be called:
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Your answer
Date of Birth
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MM
/
DD
/
YYYY
Address (Street, City, Zip)
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Your answer
Mother/Guardian's Name and Cell Phone Number
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Your answer
Father/Guardian's Name and Cell Phone Number
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Your answer
Did your child attend preschool?
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Yes
No
If you answered "yes" above, how many days a week did your child attend?
2-3
4
5
Clear selection
Please list any siblings ( Name and Age)
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Your answer
What do you view as your child's greatest strengths?
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Your answer
Are there any social, emotional, physical or academic issues that may be an area of concern?
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Your answer
What does your child like to do in his/her free time?
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Your answer
What concerns and/or goals do you have for your child in his/her Kindergarten year?
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Your answer
Does your child have any medical concerns we should know about? (Allergies, vision, hearing, diabetes, heart conditions, syndromes, asthma, seizures, dietary restrictions, dental appliances, motor restrictions, other)
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Your answer
Is your child attending SAC (School Age Care)? If yes, which days?
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Your answer
Is your child currently receiving special education services? If yes, please provide additional information.
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Your answer
Thank you for completing this survey. We look forward to seeing you soon!
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