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Keith Kindergarten Survey 2021-2022
Before Kindergarten starts, we would like to get to know your child better! We are so thankful to have your child join the Dragon Family as a student at Keith Elementary School! We would like you to please take a moment to complete this form so we might get to know your family better.
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* Indicates required question
Your Email Address
*
Your answer
Child's Name (Last, First):
*
Your answer
Child's Nickname:
Your answer
Parent's Last Name, First Name:
*
Your answer
What is your child's primary address?
*
Your answer
When is your child's birthday?
*
MM
/
DD
/
YYYY
Does your child have an Individualized Education Plan (IEP)
*
Yes
No
Other:
Can your child speak more than one language?
*
Yes
No
They do not speak English well.
What is your child's first language?
*
Your answer
What is the best phone number to reach you?
*
Your answer
My child attended preschool
*
Yes
No
Other:
May we contact you student's preschool teacher? If so, please let us know the teacher's name, which school was attended, and phone number or email, or other contact information.
Your answer
My child can recognize his/her name in print
*
Yes
No
My child can write his/her name
*
Yes
No
My child can count to 10
*
Yes
No
My child can recognize
*
A few letters
Some letters
Uppercase letters
Lowercase letters
Almost All or All Letters
My child
*
is not yet reading
can recognize his/her name
can read a simple sentence
can read easy and beginning books
can read at a high level
Please share with us the last book your child READ independently:
Your answer
My child can use the bathroom independently
*
Yes
No
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