Kindergarten Parent Questionnaire


Student's Namerequired
First Name
Middle (optional)
Last Name
Does your child have any siblings that attend an elementary school in Ansonia? If so, what school?
How does your child play/interact with friends? Check all that apply:required
Can your child follow a one step direction? (ex: Please put on your shoes)required
Does your child have the ability to follow 2-3 part directions? (ex: Go to your room, get your shoes and put them on)required
Can your child draw recognizable pictures?required
Can your child recognize his/her name in print?required
Can your child print his/her name?required
Can your child identify their colors?required
Can your child recognize these shapes: circle, triangle, and square?required
Can your child count objects up to 5?required
Can your child listen to a story from beginning to end?required
Can your child identify uppercase letters?required
Can your child dress and toilet independently?required
Does your child recognize any letter sounds?required
Does your child complete MOST tasks when requested?required
Does your child take turns, share and wait for a turn?required
Does your child verbally express his/her needs and feelings?required
My child is:required
My child uses pencils/crayons/markers.required
My child uses scissors.required
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