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2021-2022 Rose Park Kindergarten Survey
This survey is mandatory for all children registering for Kindergarten at Rose Park Elementary School. The information recorded will assist in the optimal placement of your child in a Kindergarten classroom at Rose Park Elementary School.
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* Indicates required question
Email
*
Your email
Child's first and last name:
*
Your answer
How would you like your child's name to appear on his/her name tag?
*
Your answer
What is your child's birthday?
*
MM
/
DD
/
YYYY
Parents'/guardians' names:
*
Your answer
Does your child have siblings?
*
Yes
No
If so, what are their names & ages?
Your answer
Are any of your child's siblings enrolled at Rose Park? If yes, who and what grade(s)?
*
Your answer
Home address:
*
Your answer
Parents'/guardians' phone numbers:
*
Your answer
Parents'/guardians' email addresses:
*
Your answer
Who is authorized to pick your child up from school?
*
Your answer
Where will your child go after school? (If after school care, please include name & contact information.)
*
Your answer
Do we have permission to take photos of your child for at-school use?
*
Yes
No
Does your child have any known allergies? If so, please list them here:
*
Your answer
Do you have any social, emotional, and/or behavioral concerns for your child? If so, please specify here:
*
Your answer
How does your child feel about coming to Kindergarten?
*
Your answer
Did your child attend preschool/daycare?
*
Yes
No
If so, where and for how long?
Your answer
Is your child right-handed or left-handed?
*
Right-handed
Left-handed
My child tends to use both hands interchangeably.
Has your child been exposed to using scissors?
*
Yes
No
Has your child been exposed to writing?
*
Yes
No
Does your child enjoy creating art?
*
Yes
No
Is your child able to recite the alphabet accurately?
*
Yes
No
Can your child recognize uppercase and lowercase letters?
*
My child recognizes all uppercase and lowercase letters.
My child recognizes some uppercase and lowercase letters.
My child does not recognize uppercase and lowercase letters yet.
Does your child know letter sounds a-z?
*
My child knows all letter sounds a-z.
My child knows some letter sounds a-z.
My child does not know any letter sounds yet.
Is your child able to write his/her first name with only the first letter capitalized?
*
Yes
No
My child is able to write his/her name but uses more than one capital letter.
Other:
Is your child able to write letters a-z?
*
My child is able to write all letters a-z.
My child is able to write some letters.
My child is not able to write any letters yet.
Is your child able to sound out words when reading?
*
Yes
No
Is your child able to sound out words when writing?
*
Yes
No
Is your child able to write numbers 0-20?
*
My child is able to write all of the numbers 0-20.
My child is able to write some numbers.
My child is not able to write any numbers yet.
How high is your child able to count?
*
Your answer
Is your child able to count objects correctly?
*
Yes
No
Sometimes
Is your child able to recognize numbers 0-20?
*
My child is able to recognize all numbers 0-20.
My child is able to recognize some numbers.
My child is not able to recognize any numbers yet.
Is your child able to recognize colors?
*
Yes
No
Some
What shapes can your child recognize? Check all that apply.
*
Square
Circle
Triangle
Rectangle
None of these shapes
Required
Does your child know how to handle a book ( i.e. identifying the front cover, turning the pages correctly, knowing that we read left-to-right, etc.)?
*
Yes
No
Some
Does you child enjoy listening to stories/books?
*
Yes
No
Is your child familiar with iPads/tablets?
*
Yes
No
Some
Is your child familiar with computers?
*
Yes
No
Some
Does your child prefer active or calm activities?
*
Active
Calm
Both
Has your child participated in any extra-curricular activities?
*
Yes
No
If so, what and for how long?
Your answer
Is your child able to tie his/her shoes?
*
Yes
No
Is your child able to zip his/her coat?
*
Yes
No
Is your child able to button?
*
Yes
No
Does your child know his/her full name?
*
Yes
No
Does your child know his/her birthday?
*
Yes
No
Does your child know his/her parents'/guardians' phone numbers?
*
Knows father's number
Knows mother's phone number
Knows grandparent's number
Knows guardian's number
Knows another caretaker's number
My child does not knowthe phone number of any parent, guardian or caretaker phone numbers
Does your child know his/her address?
*
Yes
No
List five adjectives you'd use to describe your child:
*
Your answer
Anything else you would like us to know about your child:
*
Your answer
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