KINDERGARTEN QUESTIONAIRRE
Child's Name:
Date of birth: (mm/dd/yyyy)
Parents' Names:
Address: City:
Home Phone: Place of Work:
Work Phone:
Ages of siblings:
The following questions are for you to consider in determining whether your child is ready for our kindergarten experience or not. Age alone is not the best indicator of a child's readiness for the program.
1. Is your child able to be alone in places outside the home without crying or becoming frightened and fearful?
2. Is your child able to take care of his/her personal needs without difficulty? (i.e. going to the bathroom, asking for something he/she needs. Every young child needs help with hard-to-button parts, snaps, shoelaces; that's expected.)
3. Is your child generally able to follow spoken directions, sometimes several at once? (Go to your room, get your shoes, and bring them to the kitchen?)
4. Is your child able to display an attention span that allows him/her to complete a task such as putting toys away?
5. Is your child able to play with other children without being overly aggressive or overly fearful?
6. Does he/she usually take turns, share, etc.?
7. Does your child "want to go" to kindergarten? (We understand that you may not know this until after attendance.)
How many of the following "survival skills" can your child do?
1. I can say my first and last name.
2. I can use the toilet, toilet paper, and the flusher.
3. I know my address.
4. I know my phone number.
5. I know what to do (and what not to do) with pencils, crayons,
paste and scissors.
6. I know my parents' first and last names. (This is especially
important if the last names are different.)
7. I can take responsibility for my own actions.
8. I can recognize my own printed name.
9. If I spill something, I try to clean it up.
10. I know how to use:
zippers
shoe laces
buttons
11. I usually can sit quietly and listen while others are talking.
12. I can share things, take turns, and play by the rules (generally).
13. I can take my outer garments (coat, mittens, etc,) on and off
by myself.
14. I can speak in a voice loud enough so that people can hear me.
Date of birth: (mm/dd/yyyy)
Parents' Names:
Address: City:
Home Phone: Place of Work:
Work Phone:
Ages of siblings:
The following questions are for you to consider in determining whether your child is ready for our kindergarten experience or not. Age alone is not the best indicator of a child's readiness for the program.
1. Is your child able to be alone in places outside the home without crying or becoming frightened and fearful?
2. Is your child able to take care of his/her personal needs without difficulty? (i.e. going to the bathroom, asking for something he/she needs. Every young child needs help with hard-to-button parts, snaps, shoelaces; that's expected.)
3. Is your child generally able to follow spoken directions, sometimes several at once? (Go to your room, get your shoes, and bring them to the kitchen?)
4. Is your child able to display an attention span that allows him/her to complete a task such as putting toys away?
5. Is your child able to play with other children without being overly aggressive or overly fearful?
6. Does he/she usually take turns, share, etc.?
7. Does your child "want to go" to kindergarten? (We understand that you may not know this until after attendance.)
How many of the following "survival skills" can your child do?
1. I can say my first and last name.
2. I can use the toilet, toilet paper, and the flusher.
3. I know my address.
4. I know my phone number.
5. I know what to do (and what not to do) with pencils, crayons,
paste and scissors.
6. I know my parents' first and last names. (This is especially
important if the last names are different.)
7. I can take responsibility for my own actions.
8. I can recognize my own printed name.
9. If I spill something, I try to clean it up.
10. I know how to use:
zippers
shoe laces
buttons
11. I usually can sit quietly and listen while others are talking.
12. I can share things, take turns, and play by the rules (generally).
13. I can take my outer garments (coat, mittens, etc,) on and off
by myself.
14. I can speak in a voice loud enough so that people can hear me.
15. I know how to used a handerkerchief or tissue and can ask for one.
Are there any particular needs your child has which would be beneficial for your child's teacher to know? Please explain.
So that we may contact you electronically, please complete the following information:
Your name:
Your e-mail address:
Are there any particular needs your child has which would be beneficial for your child's teacher to know? Please explain.
So that we may contact you electronically, please complete the following information:
Your name:
Your e-mail address:
Would you like to fill out the online enrollment form now? No problem. You can do so on this page or on the enrollment details page. Just be sure you submit the information above before entering the "online enrollment form" page. The two have to be submitted separately for us to receive the information.
E-mail: jkjohnson4411@gmail.com ** Fax Number: 580-536-2972
