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2022-23 Kindergarten Screener
Please take a few minutes to answer the questions below. These will help us get to know your child better.
* Indicates required question
Student's Last Name
*
Your answer
Student's First Name
*
Your answer
Student Birth Date
*
MM
/
DD
/
YYYY
Parent 1 (please add relation mother, father etc.)
Your answer
Parent 2 (please add relation mother, father etc.)
Your answer
Has your child had preschool experience?
*
Georgia Pre K
Private Pre K
No school experience
Other:
Intellectual Skills : Does your child...
*
Sit and Listen to a story
Hold a book upright and turn the pages
Tell and retell familiar stories
Know their first and last name
Know their phone number
Know their address
Say their ABC's
Recognize and write first name (Use capital letter in first letter of name Matt not MATT)
Recognize the letters within their name
Recognizes all uppercase letters
Recognize all lowercase letters
Reads some sight words
Knows the names of colors
Counts 0-10
Knows shapes
Holds pencil appropriately
Holds scissors appropriately
Required
Does your child have any health concerns or allergies? If you mark Yes, your child's teacher will contact you in the fall for more information.
Yes
No
Clear selection
Does your child follow any dietary preferences?
*
Vegetarian
Vegetarian but eats eggs
Vegan
Eats everything except beef and pork
Eats everything except Pork
Eats everything except Beef
Kosher
Gluten-free
None
Other:
Personal Needs Without Help: Can they...
*
Put on and take off coat
Tie their own shoes
Wash their hands
Snap, button, zip and buckle
Manage bathroom needs independently
Required
Social Skills: Can they...
*
Listen to an adult & follow simple instructions
Cooperate with other children
Sit for short periods of time
Follow simple two-step directions
Required
What are your expectations for Kindergarten?
Your answer
Is there anything you would like to tell us about your child?
Your answer
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