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District 52 Non-Family Member Questionnaire
This form needs to be completed by a non-family member (e.g. preschool teacher, childcare provider, pediatrician) for Early Entrance to Kindergarten or First Grade admission.
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* Indicates required question
Child's Name:
*
Your answer
Name of person completing this form:
*
Your answer
Relationship to child:
*
Your answer
School or Organization you are affiliated with:
*
Your answer
This child shows eagerness to learn (is curious, likes to investigate):
*
Frequently
Sometimes
Rarely or never
This child demonstrates an understanding of written print:
*
Frequently
Sometimes
Rarely or never
This child is able to sit and remain focused to complete a task:
*
Frequently
Sometimes
Rarely or never
This child interacts easily with other children:
*
Frequently
Sometimes
Rarely or never
This child is able to transition from one task to the next:
*
Easily with no issues
Is inconsistent, sometimes he/she can, sometimes it can be difficult
Not easily; this is a consistent struggle
This child is able to work on a task independently:
*
Frequently
Sometimes
Rarely or never
Please elaborate on if this child is ready for early admission to Kindergarten or First Grade and why you feel he/she is ready or not ready.
*
Your answer
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