2025-2026 Incoming Kindergarten Parent Survey

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Email *

Student's first and last name *

Gender (assigned at birth) *

Male

Female

Student's date of birth *

YYYY

Preschool Experience *

Preschool

Daycare

Other:

Does your child have a medical diagnosis that may impact him at school? (epilepsy, ADHD, etc.) *

Has your child ever been evaluated to qualify for early intervention services from a school district? If yes, please explain: *

Does your child need additional support/services in the following areas: *

Speech (example: child’s speech is hard to understand by unfamiliar listeners)

Fine Motor (example: child needs adult support to write name or cut with scissors)

Gross Motor (example: child needs help running, walking, climbing)

English Learning (example: child speaks more than one language)

Hearing

Vision

None of these apply to my child

Required

Does your child need to take medicine while at school? *

Yes

Does your child have allergies? *

Yes

Does your child need a classroom placement in our allergy classroom? *

Yes

Please select all that apply regarding your child’s behavior: *

Separation Anxiety: (example: child frequently cries when dropped off at school)

Refusal: (example. Child consistently does not follow adult instructions)

Attention: (example: child has a hard time focusing on a learning task)

Agression: (example: child shows anger by hitting others or throwing things)

None of these apply to my child

Required

When you show your child uppercase letters (out of order) they can:

Name 20-26 uppercase letters

Name 10-19 uppercase letters

Name less than 10 uppercase letters

When you show your child lowercase letters (out of order) they can: *

Name 20-26 lowercase letters

Name 10-19 lowercase letters

Name less than 10 lowercase letters

When you show your child numbers from 1-10 (out of order) they can: *

Name 8-10 numbers

Name 5-7 numbers

Name 0-4 numbers

When your child counts they can: *

Counts to 20 or higher

Counts to 10

Miscounts or skips numbers when counting or counts to a number less than 10

Please share any other information that would be helpful to us in determining the best learning environment for your child!

A copy of your responses will be emailed to the address you provided.

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