Early Kindergarten Entrance Assessment

Northshore School District

Early Kindergarten Entrance Assessment
Student Name*

First NameLast Name
Birthdate*

MonthDayYear
Date
Parent/Legal Guardian Name*

First NameLast Name
Other Parent/Legal Guardian Name

First NameLast Name
Elementary School Service Area - (based off your home address) This is the school your child will be attending. See below if you are unsure of which school your child should attend.*
Please be aware that we cannot test or accept any students that reside outside of our service area. Not sure which school your child should attend, please verify your address here
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Other Email
example@example.com
Phone Number*
Please enter a valid phone number.
Other Phone Number
Please enter a valid phone number.
NSD Early Entrance Kindergarten Checklist
Child can tell his first and last name*

YesNoSometimesNot observed
Child cuts food with a knife, e.g., sandwich, celery*

YesNoSometimesNot observed
Child can pour*

YesNoSometimesNot observed
Child dresses self*

YesNoSometimesNot observed
Child is aware that activities happen at certain times of the day, e.g., breakfast is eaten in the morning, certain TV shows occur at regular times*

YesNoSometimesNot observed
Child can hold a pencil and attempts to print name*

YesNoSometimesNot observed
Child can be away from parent several hours without becoming upset*

YesNoSometimesNot observed
Child can separates willingly from parent*

YesNoSometimesNot observed
Child can choose activities from a variety of sources*

YesNoSometimesNot observed
Child can sticks with chosen activities for 15 minutes*

YesNoSometimesNot observed
Child can wait for a turn*

YesNoSometimesNot observed
Child is aware of others' feelings*

YesNoSometimesNot observed
Child can verbalize needs*

YesNoSometimesNot observed
Child can do tasks without constant reassurance*

YesNoSometimesNot observed
Child engages in cooperative play with other children involving group decisions, role assignment and fair play*

YesNoSometimesNot observed
The child listens to directions without interrupting*

YesNoSometimesNot observed
The child listens to stories and poems for 5 to 10 minutes without restlessness*

YesNoSometimesNot observed
The child speaks clearly and can stay on topic*

YesNoSometimesNot observed
The child can give reasons for his/her own opinions*

YesNoSometimesNot observed
The child adjusts to changes in routine and to new situations without becoming fearful*

YesNoSometimesNot observed
The child adjusts to opposition or defeat without crying or sulking*

YesNoSometimesNot observed
The child adjusts to the necessity of asking for help when needed*

YesNoSometimesNot observed
The child obeys rules at home and in activities*

YesNoSometimesNot observed
The child plays cooperatively with other children*

YesNoSometimesNot observed
The child shares, takes turns, and assumes his share of group responsibility*

YesNoSometimesNot observed
The child works without being easily distracted*

YesNoSometimesNot observed
The child follow directions*

YesNoSometimesNot observed
The child completes each task*

YesNoSometimesNot observed
Child expects individual attention in a group setting*

YesNoSometimesNot observed
Child has wide mood swings*

YesNoSometimesNot observed
Child becomes frightened in large groups*

YesNoSometimesNot observed
Additional Comments/Days you will be unavailable to test
By selecting the response below, you acknowledge that your students assessment will not be scheduled until payment has been received. Address and link to online payment below.*

Yes, I will drop off the payment at the Admin officeYes, I will mail the payment to the Admin officeYes, I will pay online
Please remember to mail or drop off your payment at 3330 Monte Villa Parkway, Bothell WA 98021 or online via Touchbase. Since your child is not currently enrolled at NSD you will need to set up a guest account. Directions can be found here.
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Northshore School District

NSD Early Entrance Kindergarten Checklist