Sickles Kindergarten Pre-Registration 2023-24
Welcome to Sickles School! Thank you for taking the time to pre-register electronically.  This form will most likely take 15 - 30 minutes to complete depending on details you provide or how quickly you can access specific information. We encourage you to peruse the fields first so you can gather any and all documents or facts you may need.

This confidential information will be reviewed by our school staff. In addition, you will automatically be added to our email list for all upcoming New Student information/events.

A follow up email will be forthcoming in January regarding in-person registration for late February in order to collect the following required documents. 

Official birth certificate (with raised seal and issued from a government agency)
Two items to indicate proof of residency
         Mandatory: Driver’s License/Photo ID with address
         Mandatory: Utility bill, Tax bill, Lease, Purchase Contract, etc.
Student’s recent physical examination form (within past 6 months)
                You can download that form here:    bit.ly/3V1JJuH
Student’s immunization records
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Email *
Student's First Name *
Student's Middle Name *
Student's Last Name *
Student's Nickname
Student's Date of Birth *
MM
/
DD
/
YYYY
Student's City/Town of Birth *
Student's State of Birth *
Please write two letter abbreviation or N/A if born outside the United States.
Student's Country of Birth *
Student's Gender *
Required
Is the student Hispanic or Latino? *
Required
Student's Race *
Required
Does the student have health insurance? *
Name of Health Insurance Provider
Student's Street Address *
Student's Town *
Student's Zip Code *
Student's Temporary Address (if applicable)
Street, City, State, Zip Code
Home Phone Number *
Parent/Guardian #1 First Name *
Parent/Guardian #1 Last Name *
Parent/Guardian #1 Street Address *
Parent/Guardian #1 Town *
Parent/Guardian #1 State *
Parent/Guardian #1 Zip Code *
Parent/Guardian #1 Email *
Parent/Guardian #1 Cell Phone *
Parent/Guardian #1 Occupation *
Please list title below.
Parent/Guardian #1 Business Address
Company Name, Address, City, State, Zip
Parent/Guardian #1 Business Phone
Company Name, Address, City, State, Zip
Parent/Guardian #1 Business Email
Company Name, Address, City, State, Zip
Parent/Guardian # 2 First Name
Parent/Guardian # 2 Last Name
Parent/Guardian # 2 Street Address
Parent/Guardian # 2 Town
Parent/Guardian # 2 State
Parent/Guardian # 2 Zip Code
Parent/Guardian #2  Email
Parent/Guardian #2 Cell Phone
Parent/Guardian #2 Occupation
Please list title below.
Parent/Guardian #2 Business Address
Company Name, Address, City, State, Zip
Parent/Guardian #2 Business Phone
Company Name, Address, City, State, Zip
Parent/Guardian #1 Business Email
Company Name, Address, City, State, Zip
With whom does your child reside? *
Please list the names and ages of all siblings.
Include last name if different from student's last name.
What is the family's primary language? *
Please indicate the language most frequently spoken at home.
Does your child attend a nursery, pre-school or childcare program? *
If you answered yes, please list the name and address of the school or childcare center.
How many days/sessions  does your child attend the program above?
Clear selection
Please describe your child's literacy life at home. *
(Does your child enjoy reading at home? Does your child visit the library? Do you read together as a family? Is your child beginning to write for play (this includes scribbles) or more formally (name, numbers, etc.)?
What are some of your child's favorite activities? *
Please list a few.
Does your child have any significant fears?   *
If you selected yes, please explain below.
Does your child have a particular ability or talent in any of the following areas?   *
Please check all that apply.
Required
Has your child participated in Early Intervention Services? *
If you selected yes, please explain below.
Does your child have an Individualized Education Plan (IEP)? *
If you selected yes, please explain below.
Does your child have a 504? *
If you selected yes, please explain below.
Has your child recently had a traumatic or upsetting experience such as a family member's illness, death in the family, parent job loss, parent divorce or separation? *
This information is confidential and helps us to put support in place immediately for your child's emotional well-being.
If you selected yes,  please explain below.
Was your child born with or did s/he develop any health condition during infancy? *
If you answered yes, please explain.
Does your child have any eye or vision needs (difficulty seeing, crossed eyes, frequently reddened or watery eyes, wear glasses or contact lenses)? *
If you answered yes, please explain.
Does your child have any ear or hearing needs (frequent ear aches, difficulty hearing, draining ear, use a hearing aid)? *
If you answered yes, please explain.
Does your child have any allergies (foods, insects, medication, environmental)? *
If you answered yes, please explain.
Does your child have any other specific illness, health problem or physical limitation which might, in your opinion, affect his/her school performance or  program? (e.g.:  Speech, Heart, Asthma, Orthopedic, Diabetes,  Lyme, Epilepsy, Other) *
If you answered yes, please explain.
Has your child received any medical or other evaluation which could help school personnel in meeting his/her health or educational needs? *
If you answered yes, please explain.
Does this problem require any special health care in school? *
If you answered yes, please explain.
Does your child take medication (daily or as needed)? *
If you answered yes, please explain.
Has your child had any serious illness, injury or operation that may be important for school staff to know? *
If you answered yes, please explain.
Has your child had any of the following illnesses or diagnoses? *
Required
Please include date(s) and/or explanation(s) of items checked off above.
Has your child received a recent immunization or screening test not previously  reported? *
If you answered yes, please explain.
Do you have any concerns about your child's general health (eating and sleeping habits, bowel or bladder habits, posture, teeth, skin, weight, etc.)? *
If you answered yes, please explain.
Do you have any concerns about your child's developmental behavior or emotional well-being that the school should be aware of? *
If you answered yes, please explain.
Learning Characteristics *
Check any characteristics you have observed your child demonstrate on a regular basis.
Required
Creative Characteristics *
Check any characteristics you have observed your child demonstrate on a regular basis.
Required
Motivation Characteristics *
Check any characteristics you have observed your child demonstrate on a regular basis.
Required
Leadership Characteristics *
Check any characteristics you have observed your child demonstrate on a regular basis.
Required
I give my permission for confidential and discreet use of this information to meet my child's health and educational needs in school. *
We appreciate your time in completing this form. If you would like to provide additional information regarding your child, you may do so below. Please click the submit button below.
A copy of your responses will be emailed to the address you provided.
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