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Hamlin Elementary Kindergarten Information Form
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.
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Email
*
Your email
Student Name (First & Last
Your answer
Gender
Male
Female
Clear selection
My child prefers to be called (nickname):
Your answer
Date of Birth
MM
/
DD
/
YYYY
Address (Street, City, Zip)
Your answer
Mother/Guardian's Name and Cell Phone Number
Your answer
Father/Guardian's Name and Cell Phone Number
Your answer
Did your child attend preschool?
Yes
No
Clear selection
If you answered "yes" above, how many days a week did your child attend?
2 - 3 days per week
4 days per week
5 days per week
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Please list any siblings (Name and age):
Your answer
What do you view as your child's greatest strengths?
Your answer
Are there any social, emotional, physical, or academic issues that may be an area of concern?
Your answer
What does your child like to do in his/her free time?
Your answer
What concerns and/or goals do you have for your child in his/her Kindergarten year?
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):
Your answer
Is your child attending SAC (School Age Care)? If yes, which days?
Your answer
Is your child currently receiving special education services? If yes, please provide additional information.
Your answer
Option 1
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