Kindergarten Placement Questionnaire


Please fill out the form below to provide us with information about your child entering Kindergarten. Every Effort will be made to place your child appropriately. Therefore no request for a specific teacher will be accepted. In order to best meet your child's needs, please complete the following questions. Answers will be used to place your child in the best possible learning environment for a successful Kindergarten year.
Email address *
Child's Last Name *
Child's First Name *
Name your child goes by (if different)
Child's Birth Date *
MM
/
DD
/
YYYY
Child's Age (number only) *
Male or Female *
Student resides with: *
If student resides with "other", please identify:
Parent/Guardian #1 - First and Last Name *
Parent/Guardian #1 - Cell Phone Number *
Parent/Guardian #2 - First and Last Name *
Parent/Guardian #2 - Cell Phone Number *
Did your child attend Day Care / Preschool last year? *
If yes, which Day Care / Preschool did your child attend?
Is your child a twin/triplet? *
If your child is a twin/triplet, please list the sibling's name.
If your child is a twin/triplet, how would you prefer to have your children placed?
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