Kindergarten End-of-Year Student Assessment Questionnaire Form
Please complete the Kindergarten End-of-Year Student Assessment Questionnaire Form to evaluate the student’s development, participation, and support needs across core kindergarten areas.
Student Name
*
First Name
Last Name
Academic Skills Assessment
*
Rows
Emerging
Developing
Proficient
Recognizes letters
1
2
3
Counts to 20
4
5
6
Identifies shapes
7
8
9
Writes own name
10
11
12
Classroom Participation
*
1
2
3
4
5
Behavior and Self-Regulation
*
Rarely
1
2
3
4
Consistently
5
1 is Rarely, 5 is Consistently
Social-Emotional Development
*
Rows
Not Yet
Sometimes
Usually
Shares with peers
13
14
15
Expresses emotions appropriately
16
17
18
Works cooperatively
19
20
21
Readiness for Next Grade
*
Ready
Nearly Ready
Needs Additional Support
Student Strengths (select all that apply)
Creativity
Curiosity
Communication
Problem-Solving
Empathy
Other
Areas Where Student Needs Support (select all that apply)
Fine Motor Skills
Attention/Focus
Following Directions
Social Skills
Emotional Regulation
Other
Student’s Approach to Learning (select one)
*
Please Select
Eager and engaged
Participates with encouragement
Reluctant but tries
Needs significant support
Additional Comments
Submit Assessment
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