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McKee Road Elementary Rising Kindergarten Placement Information Form
"Get to Know my Rising Kindergartener Form" - Please complete and submit by June 1st. This form allows our administrators to learn a little more about your child.
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* Indicates required question
Email
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Your email
Student Name (Last, First)
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Your answer
Home Address: (House #, Street, City/State, Zip)
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Your answer
Parent/Guardian Name:
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Your answer
Parent Phone Number
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Your answer
Parent email address
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Your answer
Ethnicity: (Check all that apply)
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American Indian
Black or African American
Asian
White
Native American or other Pacific Islander
Hispanic or Latino
Multi
Other
Gender
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Female
Male
Birthdate
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MM
/
DD
/
YYYY
Preschool Name
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Your answer
Sibling(s) Kindergarten Teacher Name (if sibling attended McKee Road for kindergarten)
Your answer
Please check the skills or behaviors that describe your child. This information is used to help us plan our program.
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Knows address
Knows phone number
Knows birthday
Can say full name
Can print full name
Recognizes letter sounds
Plays well with others
Can use bathroom independently
Can recognize numbers 0 to 10
Knows the names of colors
Recognizes capital letters
Recognizes lowercase letters
Has experience writing with pencils
Has trouble in group setting
Likes to listen to stories
Can dress self
Can tie shoes
Counts to 10
Counts higher than 10
Destructive to property
Works independently
Happy
Affectionate
Overactive
Cries easily
Shy
Very sensitive
Attentive
Required
Has your child had preschool experience? Tell us about it.
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Your answer
Do you have an concerns with speech, health, or allergies?
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Your answer
Has your child ever received any outside services? If yes, please note the service and length of treatment (ABA, speech therapy, occupational therapy, etc).
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Your answer
What special interest does your child have?
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Your answer
List any significant fears that your child may have.
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Your answer
What responsibilities does your child have at home?
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Your answer
Is your child reading?
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Not Yet
Yes, with help
Yes, independently
What else would you like to tell us about your child?
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Your answer
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