K-1st Grade Reference Form As a parent or someone with knowledge of the applying student please complete this reference/informational form for K - 1st Grade Student Name of Student(required) How do you know this student? Teacher Pastor Friend Parent How long have you known this student? 1 year More than 1 year Has the student been in PreK or K in the last year? Yes No Maybe Unknown How much "screen time" does this child experience daily? Less than 1 hr 1-3 hours 3 + hours Unknown How much time does this child spend in outdoor activities each day Less than 1 hour 1-3 hours 3 + hours Unknown What is the child's bedtime?(required) How many hours a night is this child asleep (not just in bed) ? Less than 8 8-10 hours 10 + hours Unknown Can this child tie their shoes consistently ? Yes No Unknown Is this child being read to by a parent at home? Yes No Unkown Can this child read ? Yes No Unknown Does this child have bathroom accidents (either not telling you or not fully potty trained) ? Yes No Unknown Strengths of this child and their family(required) Weaknesses of this child and their family(required) Type the characters(required) This field should be left blank Send Please wait...