Augusta County Public Schools

Augusta County Public Schools Kindergarten Registration Attachment Complete this form only if your child did not attend an Augusta County Public School Preschool.

Child’s Name: Preschool Information, Past and Present: Does your child currently attend preschool? Yes No Did your child attend preschool? Yes No How many years? 1 2 3 More Length of time? All day ½ day Less than ½ day How many days a week? 1 2 3 4 5 How many hours per week? Less than 15 15-29 30 or more Name of Preschool/Provider: Preschool/Provider Phone: Type of Preschool Attended (Please check one): Coordinated Preschool Classroom Special Education Only Virginia Preschool Initiative Government-Tuition Charged Title I Pre-Kindergarten Private Provider Other Head Start Licensed Family Home Provider Coordinated Special Education No Formal or Institution Pre-K Unknown General Questions: Yes No 1. Can your child be away from you for 2-3 hours without being upset? 2. Can your child identify colors? 3. Can your child remember instructions and carry out 2 or 3 simple errands or tasks? 4. Can your child cut on a line using small scissors? Is your child able to stay engaged in an activity, other than television or video games 5. for 15 or 20 minutes? 6. Can your child button/zip their own clothing? 7. Can your child understand some number ideas such as one hat, two crayons? 8. Can your child identify numbers to 10? 9. Do you have books, magazines, and newspapers in your home for you and your child? Can your child sit calmly through a story when it is read and answer simple questions 10. about it? 11. Can your child recite simple verses and rhymes? Can your child tell you the meaning of simple words like ball, dog, airplane, bed, 12 water, apple, up, down, side, and short? 13. Can your child write his/her first name? 14. Can your child recognize his/her name in print? 15. Can your child recognize the letters in their name? 16. Can your child handle their bathroom responsibilities? 17. Can non-family members easily understand your child’s speech? Does you child attempt to read or write and show interest in paper and pencil 18. activities?