Early Entrance to Kindergarten Questionnaire

Children are eligible to be assessed for early entrance to Kindergarten if their 5th birth date falls between Sept. 2 and Oct. 31. Please fill out this questionnaire, attach a scan or photo of your child’s birth certificate and pay $125 through Eleyo by June 1. If you decide not to have your child assessed, you may request a refund of $100 ($25 non-refundable).

If you have questions regarding the Early Entrance form or process, please contact Susie Hill (hills@stillwaterschools.org).

Child's Namerequired

First Name

Middle (optional)

Last Name

Suffix (optional)

Verified Date Of Birth

MM/DD/YYYY

Parent/Guardian Namerequired

First Name

Middle (optional)

Last Name

Suffix (optional)

Parent/Guardian Email Addressrequired

Telephone:

XXX-XXX-XXXX

Street Address

City

State

MN, WI, etc

Zip

Elementary School Arearequired

Alternate/Preferred Placement

List names and birth dates of brothers and/or sisters:

Is this child able to dress completely without help, except for tying shoes?required

Yes

Including tying shoes? required

Yes

Able to dress in winter clothing? required

Yes

At what age did your child walk?

At what age did your child talk?

At what age was your child toilet trained?

Does your child prefer:

To play alone?

With one or two other children?

With a group of children?

How many of your child’s playmates are already in school?

How many of your child’s playmates are entering kindergarten?

How many of your child’s playmates are still too young for school?

What are your child’s favorite play activities with other children?

What stories has your child particularly enjoyed?

What are your child’s favorite television programs?

In what family activities does your child like to participate?

Are there limitations to physical activities? required

Yes

Please state reason

Child’s present heightrequired

Child’s present weightrequired

What have your child’s preschool experiences been thus far?

If he/she has attended a nursery school or day care, list school’s name, and number of years of attendance.

Please state the reasons why you wish your child to enter kindergarten early. Include your personal evaluation of your child’s exceptional mental ability, and social and emotional maturity. Since you spend so much time with your child, your observations are important.required

Image/Scan of Child's Birth Certificaterequired

Attach up to 1 file with a maximum size of 16MB

No file chosen

Checklist for Consideration

To be given consideration, please;

Fill out all required fields on this form
Upload a digital copy of child's birth certificate (photo of birth certificate from your smart phone is adequate)
Pay the processing fee of $125 through Eleyo (if you qualify for Free/Reduced lunch, you can request a fee waiver).
Apply for consideration by June 1

Early Entrance to Kindergarten Questionnaire