Request for Kindergarten Placement outside of SCDE Enrollment Guidelines
SCDE Enrollment Guidelines require that a child turning six years old on or before September 1 of the current school year enroll in 1st grade. The completion of this form allows a parent/guardian to formally request that their child be placed in kindergarten for the upcoming school year due to extenuating circumstances that warrant consideration for kindergarten placement.
NOTE:
If applying to a Program Option, requests should be submitted prior to submitting a Program Option application. Program Option applications typically open in early January of the current school year. For enrollment in zoned schools, requests should be submitted February 1-July 31 prior to the new school year.
Parent or Guardian completing this form
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First Name
Last Name
Relationship to the child
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Mother
Father
Guardian
Child's Full Name
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First Name
Last Name
Child's Date of Birth
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Month
-
Day
Year
Date
Child's Current Address
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Street Address
Street Address Line 2
City
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State
Zip Code
Please select your Zoned School
Please Select
Cherry Park Elementary
Ebenezer Avenue Elementary
Ebinport Elementary
Independence Elementary
India Hook Elementary
Lesslie Elementary
Mount Gallant Elementary
Mount Holly Elementary
Northside Elementary
Oakdale Elementary
Old Pointe Elementary
Richmond Drive Elementary
Sunset Park Elementary
York Road Elementary
Are you applying to a Program option?
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Yes, I have applied for my child to participate in a district Program Option.
No, I would like my child to attend our zoned school.
Best email address to reach parent/guardian
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example@example.com
Best phone number to reach parent/guardian
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Please enter a valid phone number.
CHECK ALL THAT APPLY
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Developmental Delay (Documentation may include results from a developmental screener, evaluated by a school psychologist or licensed early childhood specialist)
Lack of Prior Schooling or Limited Educational Exposure (Documentation may include a written statement from a parent/guardian or absence of prior educational records)
Medical Condition or Health Related Issue (Documentation may include a physician's statement or documentation from a prolonged hospital stay)
Social and Emotional Immaturity (Documentation may include reports from a counselor or the like or observation notes from an early childhood provided)
Significant family or life disruptions (Documentation may include court records, social worker reports or evidence of foster care, adoption, or trauma)
Previous Academic Recommendations (Documentation may include written recommendation from a current early learning provider or official transcript/progress report from an early learning program)
Documentation is required. Please upload all documentation to support this request.
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Please describe the reasons for your request and any additional information that would support your child's placement in kindergarten outside of the SCDE guidelines for Kindergarten age requirements:
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I have read and understand the Standard Operating Procedure for Kindergarten and 1st Grade Enrollment. A final decision will be communicated in writing to the parent who submitted the request within 10 business days of the submission.
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