F-1 3110
APPLICATION FOR EXCEPTION TO ADMISSION AGE POLICY
DIRECTIONS: Complete all parts of this application form. The application may be
submitted no earlier than the date of kindergarten registration for the following year. The
District office can inform you of this date. A nonrefundable application fee as
established by the Board to cover costs of testing must be submitted at time of
application. A check or money order may be made payable to the “Kennewick School
District”.
PART I: IDENTIFYING INFORMATION
Child’s Name ________________________________Birthdate________
(Last
First
Middle)
Elementary School Student would attend: _________________________
Parent/Guardian Name: ________________________________________
Street Address: ________________________ City______________ Zip________
Phone Numbers:
Home:___________ Work:__________
PART II: DEVELOPMENTAL INFORMATION
1. What group experience has your child had: Preschool, church school, daycare center,
etc.? How old was your child, and how long did the experience last?
2. How does your child react to being left with others in a group situation?
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Application for Exception to Admission Age Policy – Continued
3. What are the ages of your child’s closest playmates? How often does your child play
with other children?
4. How long will your child sit and listen to a story?
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Administrative Regulation No. F-1 3110
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5. What quiet activities does your child most enjoy doing? About how long will your
child concentrate on a single activity?
6. Does your child have any special interests, hobbies or collections? Please list.
7. Does your child show interest in letters, words and numbers? If so, how many does
your child know?
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Application for Exception to Admission Age Policy – Continued
8. Does your child read? If so, how did your child learn? What materials is your child
reading?
9. Can your child follow a sequence of three directions, for example, hang up your coat,
let the dog in and get your snack?
10. Does your child enjoy riddles and jokes?
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Administrative Regulation No. F-1 3110
Application for Exception to Admission Age Policy – Continued
11. For considering early placement, what additional information should we have about
your child? (e.g., problem solving, creativity, special abilities).
12. What are the benefits you expect for your child from early admission to school?
Printed Name: _________________________________________
Signed: _________________________________________
Relationship to Child: ___________________________________
Date of Application: ____________________________________
April 18, 2003
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