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Application: Early Entrance to Kindergarten
Complete this application if your child was born between August 2 and October 1, 2014 and you believe your child demonstrates academic achievement, social, emotional and physical maturity appropriate for kindergarten placement. A district committee will review the applications and make contact to schedule the assessment.
Email address *
Email *
Your answer
Potential Student/Guardian Information
Please complete the following.
What is your child's full name? *
Your answer
What is your child's birthdate? (Month/Date/Year) *
Your answer
What is your address? *
Your answer
Parent/Guardian's full name: *
Your answer
Phone number: *
Your answer
Preschool Experience
List the preschools or other child care programs attended. Include the dates of attendance and the approximate number of hours per week attended.
Name of School/Program, Date of Attendance, Number of Hours Per Week: *
Your answer
Name of School/Program, Date of Attendance, Number of Hours Per Week:
Your answer
Name of School/Program, Date of Attendance, Number of Hours Per Week:
Your answer
Name of School/Program, Date of Attendance, Number of Hours Per Week:
Your answer
Parent Checklist
This checklist will help to determine your child's readiness to enter school at an early age. Please read each statement and indicate your child's abilities as listed by checking the appropriate response.
Performs self-help tasks independently (dressing, undressing, zipping, tying). *
Uses eye/hand coordination to perform fine motor tasks (drawing, writing, and cutting). *
Uses balance and control to perform large motor task (walking, jumping, and skipping). *
Shows eagerness to learn (curious and asks interesting questions). *
Follows rules and routines. *
Handles change and transition well. *
Interacts and plays well with other children. *
Is able to separate from parents, demonstrating security? *
Works and plays independently. *
Works until a task is completed. *
Demonstrates responsibility by caring for materials and belongings. *
Understands and follows two-step directions. *
Listens for meaning in stories, discussions, and conversations. *
Speaks clearly to share ideas and thought. *
Can identify all letters. *
Can sound out sight words phonetically. *
Uses letters to write words. *
Writes full name. *
Can recognize numbers 0-20 and use them in context. *
Can read number words and count forward to 30. *
Can recognize and extend simple patterns (circle-triangle, circle-triangle, circle-triangle). *
Can recognize and describe shapes. *
Demonstrate understanding of positional words (up, in, near, under, over, behind). *
Demonstrate understanding of time (before, after, tomorrow, yesterday). *
Recognizes self and others as having same and different characteristics. *
Describes roles and responsibilities of people (Firefighters, put out fires). *
Recognizes the reasons for rules. *
Parent Questionnaire
Please answer each question below.
Why do you feel your child should be considered for early admission to kindergarten? *
Your answer
In what types of activities does your child participate and can he/she focus for an extended period of time? *
Your answer
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