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May Watts Kindergarten Information Sheet 21-22
Complete this form for students who will be entering kindergarten in the 2021-2022 school year.
( Child must be the age of 5 on or before September 1, 2015 - August 31, 2016. )
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* Indicates required question
Email
*
Your email
Legal Student First Name
*
Your answer
Student Middle Name
Your answer
Student Last Name
Your answer
Gender
Female
Male
Prefer not to say
Clear selection
Date of Birth
*
MM
/
DD
/
YYYY
Parent/Guardian First and Last Name
*
Your answer
Current Address
*
Your answer
Subdivision
Your answer
Phone Number
*
Your answer
Primary language spoken in the home
*
Your answer
Race/Ethnicity
*
Hispanic or Latino
American Indian or Alaskan Native
Asian
Black/African American
Native Hawaiian or other Pacific Islander
White
Did your child attend preschool?
*
Yes
No
If yes, name of preschool attended
Your answer
Do you have other children attending D204?
*
Yes
No
If yes, what school are they attending?
Your answer
Does your child play well with other children his or her own age?
*
Yes
No
Required
Does your child like to play alone?
*
Yes
No
Required
Does your child follow your rules?
*
Yes
No
Required
Does your child eat without help?
*
Yes
No
Required
Can your child use the bathroom without help?
*
Yes
No
Required
Are you able to understand what your child wants or needs?
*
Yes
No
Required
Can your child follow a two-step direction (go upstairs and get your coat)?
*
Yes
No
Required
Does your child yell a lot?
*
Yes
No
Required
Does your child receive care from a doctor or have a medical plan? (example: Asthma, allergies)
*
Your answer
Does your child take medication?
*
Your answer
Does your child have any food restrictions?
*
Your answer
Academics: Please check boxes to show your child's skills: My child...
Can say the letters of the alphabet
Can say the sounds each letter makes
Can put on his or her own shoes
Will answer to his or her name
Knows all the letters in his or her name
Can write his or her name
Can tie his or her own shoes
Can zip, button or snap his/her own coat
Can count to 10 (in what langue)
Your answer
Can count things up to:
Your answer
Knows another language (name of language):
Your answer
Health concerns, other services needed, or any additional information you wish to share:
Your answer
A copy of your responses will be emailed to the address you provided.
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