11
March 2012 Kendall Kaleidoscope KENDALL ELEMENTARY SCHOOL 2408 Meadow Lake Drive Naperville, IL 60564 Main Phone: 630-428-7100 Attendance Line: 630-428-7100 #3 On the web: http://kendall.ipsd.org Kendall PTA - together making a difference in the lives of our children. Principal’s Message Home of the PATRIOTS Dear Kendall Families, Our fourth grade students sang and danced the night away when they performed their musical “Camp Kendall” on January 31 st . In front of family and friends, they shared their musical talents. Thank you to Mrs. Burck, the fourth grade teachers and many staff members and families who contributed to our students’ success. Students will certainly remember this awesome performance for many years! PTA sponsored Valentine’s parties brought fun to all our students. We are fortunate to be supported by such wonderful room parents. Thank you very much! The fifth grade students participated in their “Jump Rope for Heart” activity. Good exercise and calorie burning was had by all! We thank Mr. Popovich for his detailed planning of this special 5 th grade event. He also was supported by an energetic group of parent volunteers. Three thousand, one hundred and five dollars were collected for the American Heart Association. February’s Open House was a great success! Thank you for attending. The children are so proud of their school, and it showed as parents and children crowded the hallways with smiles and pride. As a staff, we felt fortunate to enjoy the evening with all of you! Please keep in mind that ISAT testing started on Monday, March 5 th for grades 3 through 5 and will continue through March 13 th . Participation rates for No Child Left Behind must be at least 95%. We ask that you make every effort to have your child in attendance during ISAT testing. Thank you for your help! Sincerely, Lena Guerrieri Principal If you do not utilize Kendall’s pick up lines please read on: Parents, We encourage you to please not cross your children in a non-designated crosswalk zone. By choosing not to utilize the pick-up lines, your child is in danger of moving traffic on Meadow Lake Drive during heavy trafficked times of day. Drivers have difficulty seeing students cross onto Haider Avenue and Ayrshire Court. Please assist us in keeping ALL kids safe and utilize the pick-up lines or cross walk areas designated by the Naperville Police Department.

Kendall Kaleidoscopekendall.ipsd.org/uploads/PTA/March_2012_Kaleidoscope.pdfKendall Kaleidoscope Page 3 2012 Jump Rope for Heart During our Valentine parties at Kendall, the 5th grade

Embed Size (px)

Citation preview

Page 1: Kendall Kaleidoscopekendall.ipsd.org/uploads/PTA/March_2012_Kaleidoscope.pdfKendall Kaleidoscope Page 3 2012 Jump Rope for Heart During our Valentine parties at Kendall, the 5th grade

March 2012Kendall Kaleidoscope

KENDALL ELEMENTARY SCHOOL2408 Meadow Lake Drive Naperville, IL 60564

Main Phone: 630-428-7100 Attendance Line: 630-428-7100 #3 On the web: http://kendall.ipsd.orgKendall PTA - together making a difference in the lives of our children.

Principal’s Message Home of the PATRIOTS

Dear Kendall Families,

Our fourth grade students sang and danced the night away when they performed their musical “Camp Kendall” on January 31st. In front of family and friends, they shared their musical talents. Thank you to Mrs. Burck, the fourth grade teachers and many staff members and families who contributed to our students’ success. Students will certainly remember this awesome performance for many years!

PTA sponsored Valentine’s parties brought fun to all our students. We are fortunate to be supported by such wonderful room parents. Thank you very much! The fifth grade students participated in their “Jump Rope for Heart” activity. Good exercise and calorie burning was had by all! We thank Mr. Popovich for his detailed planning of this special 5th grade event. He also was supported by an energetic group of parent volunteers. Three thousand, one hundred and five dollars were collected for the American Heart Association.

February’s Open House was a great success! Thank you for attending. The children are so proud of their school, and it showed as parents and children crowded the hallways with smiles and pride. As a staff, we felt fortunate to enjoy the evening with all of you!

Please keep in mind that ISAT testing started on Monday, March 5th for grades 3 through 5 and will continue through March 13th. Participation rates for No Child Left Behind must be at least 95%. We ask that you make every effort to have your child in attendance during ISAT testing. Thank you for your help!

Sincerely,

Lena GuerrieriPrincipal

If you do not utilize Kendall’s pick up lines please read on:

Parents,

We encourage you to please not cross your children in a non-designated crosswalk zone. By choosing not to utilize the pick-up lines, your child is in danger of moving traffic on Meadow Lake Drive during heavy trafficked times of day. Drivers have difficulty seeing students cross onto Haider Avenue and Ayrshire Court. Please assist us in keeping ALL kids safe and utilize the pick-up lines or cross walk areas designated by the Naperville Police Department.

Page 2: Kendall Kaleidoscopekendall.ipsd.org/uploads/PTA/March_2012_Kaleidoscope.pdfKendall Kaleidoscope Page 3 2012 Jump Rope for Heart During our Valentine parties at Kendall, the 5th grade

Page 2Kendall Kaleidoscope

Kendall Families, PTA is hard at work on some very special events we all look forward to! Our Mother/Daughter Bowling Night is Friday, March 16th, 5-7pm. Forms were sent home and can be located on our Kendall website as well. We look forward to seeing all the Kendall ladies on this very special night. The Father/Son Event is in the final stages of planning, and details will be coming out soon! Our spring parties are in full bloom and are scheduled for Thursday, March 22nd from 2:15-3pm. We thank all the parent volunteers who are planning this day for our students. PTA is once again assisting the 5th graders with the cost of their annual 5th grade field trip. We have two very important fundraisers this month which will help reduce the cost for each student. Please look in your child’s backpack for the Market Day dessert order form coming home soon! Please buy a dessert and help our 5th graders reach their goal to sell 100 desserts!! Also, don't forget about our Jet's Pizza Night on Wednesday, March 14th. All proceeds from this restaurant night will go towards the 5th grade Civil War Experience Field Trip. Please help our 5th graders while feeding your family a delicious meal! Our Kendall Skate Night is on Wednesday, March 21st. We hope you can join us for a night of skating and fun! We are very excited about Kendall Elementary’s very first Science Fair, which will be held on April 16th. Thank you to all the very creative individuals who entered this year!! Lastly, Kendall PTA is partnering with the Mixed Bag Designs company for a Spring Fundraiser. This company designs adorable, affordable, reusable bags, while helping make our world a more colorful and "greener" place to live! Please help support the PTA and help save our environment when this fundraiser takes place in April - just in time for Earth Day!! As always, thank you for supporting the PTA and Kendall School. Christine Henderson & Vicky ChowPTA Presidents

Presidents’ Message

Page 3: Kendall Kaleidoscopekendall.ipsd.org/uploads/PTA/March_2012_Kaleidoscope.pdfKendall Kaleidoscope Page 3 2012 Jump Rope for Heart During our Valentine parties at Kendall, the 5th grade

Page 3Kendall Kaleidoscope

2012 Jump Rope for Heart

During our Valentine parties at Kendall, the 5th grade classes had the opportunity to participate in the American Heart Association's 2012 Jump Rope for Heart event. The concept behind this very important day is to educate our students on the importance of maintaining a healthy lifestyle. The lessons taught included the promotion of physical activity, good nutrition, awareness and reduction of heart disease risk factors. This year's fifth grade had the opportunity to collect donations for the American Heart Association to help the fight against heart disease and stroke. I am so pleased to announce that this year's 5th grade students raised $3,105 toward this very worthy cause.

The 5th graders were able to come down to the gym and jump rope during this exciting afternoon. Their efforts and camaraderie were most impressive! Thank you to all the 5th grade students and their teachers for their wonderful leadership. I also want to thank all the parent volunteers (and Kendall PTA), who helped to make Jump Rope for Heart such a memorable afternoon for our 5th grade students.

Mr. PopovichPhysical Education

IPPC  Meeting  Thursday,  February  16,  2012

Dr.  Kathy  Birkett,  Superintendent-­‐

We  have  a  3.5  million  dollar  budget  deEicit  with  an  additional  8  million  that  has  to  do  with  initiatives  that  we  have  to  be  prepared  for.    There  will  be  principal  and  teacher  evaluations,  all  of  which  were  supported  by  our  teachers.        These  will  also  be  tied  to  online  student  assessments.    Dr.  Birkett  stated  that  this  is  the  right  thing  to  do  for  student  achievement.    In  addition,  a  demographic  study  has  to  be  done.

We  observed  a  moment  of  silence  for  Spring  Brook  Elementary’s  2nd  grade  teacher,  Shaun  Wild,  and  a  senior  from  Neuqua  Valley,  Megan  Miller.

Registrations  will  be  done  online  for  the  school  year  2013/2014  starting  with  high  school.    

Reminder  of  the  Student  Summer  Activities  Fair,  March  7  @  Still  Middle  School,  6-­‐8pm.    So  far,  there  are  34  vendors  scheduled.

Christy  RussellIPPC  Representative

Page 4: Kendall Kaleidoscopekendall.ipsd.org/uploads/PTA/March_2012_Kaleidoscope.pdfKendall Kaleidoscope Page 3 2012 Jump Rope for Heart During our Valentine parties at Kendall, the 5th grade

Page 4Kendall Kaleidoscope

Math PLC

Mrs. Shafron 4th grade teacher

Flexible groupings in math continue to promote individualized instruction to meet the needs of all learners. Students are routinely monitored and assessed to determine the correct instructional placement. Since these groups are flexible, it is possible your child may see another teacher for math instruction.

Currently four groups of Mathletes meet after school on Mondays and Thursdays. Students who were recommended for this group have the opportunity to practice skills and have extra support from third fourth or fifth grade teachers.

Our last EDM Parent Night was a big success. Parents had the chance to learn and play math games that students play during math class. They were shown examples of each of the different “partial” methods such as partial sums and partial products. Attendees also were able to view new websites to enhance math practice at home. A lucky few even walked out with a prize! We hope to see you at the final EDM Parent Night on Monday, April 23.

Publishing CenterCongratulations to the following writers for completing stories in the Publishing Center from mid-January to mid-Februrary:

From Mrs. Donivan’s class: Nupur Khanvilkar, Sarah Kuper, Claire Peterson, Natalie Rappe, Elise Storoe, and Lauren Verdun

From Mrs. Kalantzis' class: Mitchell Brouder, Keri Kaczmarowski, Reva Khadilkar, Kaitlyn Robinson, Delaney Sanders, and Madison Sheriff

From Ms. Spires’ class: Julia Bradley, Nicholas Pintar, Angela Tan, and Saloni Vaishnav

From Mrs. Field’s class: Caitlyn McGrath, Nicole Sterchele, and Maura Tangney

All students from second grade to fifth grade can complete a story at the Publishing Center. Students are encouraged to talk to his/her teacher about arranging a time to publish a story.

Birthday Book Club

We have some great new titles in the LMC from these new Birthday Book Club members! Thanks to all the awesome Kendall kids for their donations!

Asha Davis-OliviaGracie Hargrove-SilverliciousJonathan Mannisto-Nat Geo Kids Ultimate Weird but TrueShreya Pai-Mallory on the MoveBrendan Sudol -Big Book of TrainsKyle Sudol-Robots! Draw Your Own…Joshua Vierke-Dragonbreath: Attack of the Ninja Frogs These books are ready for check-out. Look for them on the Birthday Book Club display! To become a BBC member, just donate a hardcover book to the LMC in honor of your birthday. If you have a question regarding the Birthday Book Club program please contact Heidi Holm @ (630) 904-2801 or [email protected].

Page 5: Kendall Kaleidoscopekendall.ipsd.org/uploads/PTA/March_2012_Kaleidoscope.pdfKendall Kaleidoscope Page 3 2012 Jump Rope for Heart During our Valentine parties at Kendall, the 5th grade

Page 5Kendall Kaleidoscope

Market DayDID YOU KNOW???...that Market Day is gourmet quality food at reasonable prices!...that most Market Day products are packaged individually allowing you to thaw only the amount you need for your meal, no waste!...that most Market Day meals take less than 30 minutes to prepare! Great for families on the go!!!…that Market Day accepts the LINK card at the sale!...that our school receives at least 10% profit every month!!

MARCH PROMOTION- FREE 1 lb. Pork Tenderloin with $90 online purchase*Promo Code: MARBONUS*PretaxNEW THIS MONTH-Stuffed Peppers, #1695A classic comfort food. Delicious individual entrées, made with green bell peppers stuffed with white rice, groundbeef & tomato sauce. 4-10 oz../$13.49Shrimp Scampi, #2156Deliciously convenient. Delicate & tender large shrimp enrobed in a butter & garlic sauce. Easy skillet meal inminutes. 2-8 oz. pouches/$12.99Margarita Tilapia, #2114Hint of lime on a lightly breaded mild, moist, and flaky fish. Sustainably raised. Bakes up extra crispy.5-8 fillets/1.5 lbs./$12.99

DESSERTSMany to choose from...plus our school will receive bigger profits on all desserts purchased!Try the new Lemon cake or Key Lime Pie!!Delivered just in time for Easter, Mother's Day, Communions, Graduations and many other Springtime Events!!

Freequent Buyer-GET YOUR FREE INSULATED COOLER IN MAY!If you make two purchases of $40 or more (pretax) between February and April, simply make a 3rd order of $40 or more (pretax) in May to receive your FREE Insulated Cooler bag at your May sale pick-up. REMINDERS: MARKET DAY ORDERS DUE TO SCHOOL: Friday, March 16th.or you can place your order on-line @ www.marketday.com until Saturday, March 17th @ 11pmMARKET DAY PICK-UP IS: Wednesday, March 21st 6-7pm in the Kendall Gym

AS ALWAYS, WE NEED VOLUNTEERS If you are interested in volunteering just one hour of your time, please consider volunteering for Market Day. Each month we raffle two Market Day gift certificates and each time you volunteer, your name goes into that raffle! Our school sale is Wednesday, March 21st and we need volunteers from 5-6pm. For information on the Market Day program or to volunteer your time, please contact the Market Day chairpeople...Christine Henderson (630)922-5424 or Laurie Korinek, (630)922-9926.

Page 6: Kendall Kaleidoscopekendall.ipsd.org/uploads/PTA/March_2012_Kaleidoscope.pdfKendall Kaleidoscope Page 3 2012 Jump Rope for Heart During our Valentine parties at Kendall, the 5th grade

Page 6Kendall Kaleidoscope

Winter Reading ProgramOur LMC-sponsored winter reading program, “Be a Smart Cookie…Read!” concluded on February 22. Those students who met their reading goals each week returned paper cookies which were placed inside grade level cookie jars on our giant LMC wall display. In order to qualify for the Kane County Cougars baseball game voucher as well as the Six Flags free student admission, reading logs had to be returned. These reading logs were mailed to Discovery Education which coordinates the Six Flags Read to Succeed program. They use the paper reading logs to verify qualifying students entered online. If students did not return reading logs promptly they would not qualify for the Six Flags free student admission. Six Flags tickets will not arrive until late April or early May and will be distributed to qualified students at that time.

Greetings from the LMC!

The months sure seem to be flying by. Here’s the latest from the LMC.

Kin Connect

February’s program was based on the book entitled Matreshka by Becky Hickox Ayres. The story is about a little girl, Katia, who gets lost during a snow storm and finds refuge at a house in the woods. Unfortunately, Baba Yaga lives in the house and she decides Katia would make a great dinner! Using Matreshka dolls the story evolves into a suspenseful adventure where Katia tries to escape. The story has a wonderfully happy ending, and the students enjoy seeing all of the sizes of the stacking doll (or Matreshka) used throughout the story. The children bring a bookmark and Matreshka doll that they can decorate home. What a fun book! Thank you to the parents who provided this month’s activity!

Page 7: Kendall Kaleidoscopekendall.ipsd.org/uploads/PTA/March_2012_Kaleidoscope.pdfKendall Kaleidoscope Page 3 2012 Jump Rope for Heart During our Valentine parties at Kendall, the 5th grade

Page 7Kendall Kaleidoscope

LMC/Lab ClassesHere is what each grade level accomplished last month.

Kindergarten

Students created “All About Me” slides for an Open House slideshow. They had to identify what they could find at school, what they liked, what they could find at home, what they were good at and what they did not like. This activity gave students the opportunity to practice clicking and dragging pictures to specific areas of their slide. They also used the keyboard to type their names on their slides. The individual slides were merged into a slideshow and put to music for everyone to enjoy at Open House.

We began an author study on Australian author, Mem Fox. We shared books like Possum Magic about a little possum who was made invisible by her grandmother and wishes to be visible again. Grandma Poss can’t find the magic spell to make Hush visible again but remembers it had something to do with people food. So they travel all around Australia to find the foods that will make Hush visible again. Wilfrid Gordon McDonald Partridge is named after Mem’s grandfather and is about a little boy who visits a home for older people. He discovers Miss Nancy has lost her memory and sets out to restore her memory. Here is the website for Mem Fox if you want to learn more about her http://www.memfox.com.

The students took a technology pre-assessment online to see what they know about the parts of a computer. They will take the assessment again in May to check their progress.

1st Grade

The Chinese New Year dragon kite with first graders’ handprints on the tail was on display for Open House. Students began an author study on author/illustrator, Eric Carle. Students viewed Eric Carle, Picture Writer, a movie that showed how Eric Carle creates his collage illustrations. He showed how he paints his own tissue papers that he uses to create his collages. Mr. Carle begins an illustration by creating a simple pencil or crayon sketch. He uses the sketch to form the shapes for the collage and then cuts the shapes from the painted tissues he has created. The movie showed students how Carle created a page from his famous The Very Hungry Caterpillar. We shared Eric Carle’s book The Grouchy Ladybug and created clocks to use with the story. Two ladybugs met on a leaf full of aphids. One ladybug was sweet and willing to share the aphids, but the other ladybug was grouchy and wanted them all for itself.

Page 8: Kendall Kaleidoscopekendall.ipsd.org/uploads/PTA/March_2012_Kaleidoscope.pdfKendall Kaleidoscope Page 3 2012 Jump Rope for Heart During our Valentine parties at Kendall, the 5th grade

Page 8Kendall Kaleidoscope

The story continues with the grouchy ladybug running into larger and larger creatures until it finally finds itself back where it started from and is willing to share the aphids with the sweet ladybug. Throughout the story each creature the grouchy ladybug meets is at a specific time of day. With the clocks students created they set their clocks for the time of day on each page of the story. Learn more about Eric Carle at http://www.ericcarle.com.

First graders took a technology pre-assessment online to see what they know about the parts of a computer. They will take the assessment again in May to check their progress.

2nd Grade

Students completed their state research using the online resource Facts4Me. They had to find information about the state’s name, important cities like the capital and largest cities, the population, famous people from the state and fun facts about the state. Second graders created state slides with the symbols from their states that were merged into a slideshow for Open House. Students practiced clicking and dragging pictures to their correct locations, highlighting information, copying and pasting information and typing the names of their states and their own names on their slides.

Students participated in the Naperville Reads program by attending a presentation by author/storyteller, Antonio Sacre, at Metea Valley High School on Thursday morning, February 9. The children were treated to Sacre’s stories, A Mango in the Hand, La Noche Buena andThe Barking Mouse which he told in English and Spanish.

3rd GradeAfter completing their habitats research, students practiced their keyboarding skills using Tux Typing and learning the home row keys and which fingers are responsible for striking each key.

We reviewed the Accelerated Reader program we have at Kendall. This program matches books from our LMC collection with quizzes that were purchased for the Accelerated Reader program. Students select AR books, take the appropriate quiz, and if they pass the quiz they will accumulate points. Reaching milestone point totals entitles the student to certain rewards. These rewards are awarded at the end of each quarter. Accumulated points carry over each year until the student leaves Kendall. We shared a special AR book entitled Horrible Harry and the Dungeon by Suzy Kline and then took the AR quiz on the book together. Students were each awarded 1 point for passing the quiz. The children were encouraged to continue participating in the Accelerated Reader program.

Page 9: Kendall Kaleidoscopekendall.ipsd.org/uploads/PTA/March_2012_Kaleidoscope.pdfKendall Kaleidoscope Page 3 2012 Jump Rope for Heart During our Valentine parties at Kendall, the 5th grade

Page 9Kendall Kaleidoscope

Third graders had the opportunity to visit with an author, Katherine Applegate, on Friday, February 17, in the LMC. Mrs. Applegate’s new book The One and Only Ivan was published in mid-January, and Kendall was lucky to be able to host her. Students learned all about her new book and what it’s like to be a published author.

4th GradeMaking inferences was the focus for our learning during the last month. After reading Dandelions by Eve Bunting, students were partnered up and given an activity where they had to infer character traits for a specific character from the fiction book. Partners had to provide specific text references from Dandelions that identified specific character traits for their character. They had to use knowledge they already had plus the text from the book to infer what type of person their assigned character was. Students were shown the skulls of nine different mammals and were provided information related to the skulls. Using the information given about mammals, the students had to make inferences related to diet, vision, and hunting ability. These enrichment activities helped the students prepare for ISAT testing.

5th GradeStudents completed their web quest (electronic activity using the internet) on the Revolutionary War. This activity reviewed the Revolutionary War period in American History that was covered in the classroom and also provided new information for students about this period. The students had to learn to work between two different documents on the computer. They had the web quest and an answer sheet minimized on their taskbars and had to toggle between the two documents. Students practiced highlighting on their answer sheets to type answers to web quest questions. They practiced following links and searching for answers asked in the web quest. Finally, students had to print their answer documents and submit them to Mrs. Gutmann.

If you have any questions related to the LMC, please don’t hesitate to contact me either by email [email protected] or phone (630) 428-7106.

Page 10: Kendall Kaleidoscopekendall.ipsd.org/uploads/PTA/March_2012_Kaleidoscope.pdfKendall Kaleidoscope Page 3 2012 Jump Rope for Heart During our Valentine parties at Kendall, the 5th grade

Page 10Kendall Kaleidoscope

Kendall Elementary School Indian Prairie Community School District 204

2408 Meadow Lake Drive Naperville, IL 60564

(630) 428-7100 Lena Guerrieri, Principal

January 2012 Dear Parents: If you have a child who will be five (5) years old on or before September 1, 2012, he or she is eligible to enroll in kindergarten for the 2012-13 school year. We are pleased to offer ALL-DAY kindergarten for your child. A HALF DAY kindergarten class is also available. The hours for both of the options as follows: Half day 9:05-11:50 A.M. or 12:50-3:35 P.M. (your child will be assigned to either AM or PM) All Day 9:05 A.M.-3:35 P.M. You are being asked to indicate your preliminary choice of all day or half day kindergarten on the attached form. You are invited and encouraged to attend a Kindergarten Parent Preview Night on Monday, March 12, 2012 at 7:00 P.M. in the gymnasium. At this meeting, we will provide a detailed look at what the kindergarten experience will offer. You will also be provided with more details related to registration requirements and deadlines. This night is designed for parents and guardians only. At the end of the March Parent Preview Night meeting, you will be able to fill out a form to inform us if you wish to change your placement choice indicated on this pre-registration form. Parents are encouraged to return registration materials as soon as possible for planning purposes. The final deadline is May 25, 2012 after which changes in placement cannot be accommodated. Please note that if you select the half day option, your child may not necessarily attend his or her home school. Buses will be provided if your child attends a half day program at another school. Pre-registration and registration materials will be used to anticipate the need for half day kindergarten classes, but final decisions, including location, will not be made until after the registration deadline of May 25, 2012. We need the Pre-Registration information on the attached sheet as soon as possible so that we can begin planning kindergarten enrollment for the upcoming school year. This Pre-Registration information will be used to form a kindergarten mailing list. Once on the mailing list, additional information will be mailed to eligible kindergarten parents. If you have any neighbors who do not presently have school-aged children, but will have an incoming kindergartner, please give them a copy of this form or ask them to call our office at 630-428-7100 so that we can send them this information. I look forward to meeting you at the Kindergarten Parent Preview Night. Please mark your calendars!

Kindergarten Parent Preview Night Monday, March 12, 2012 at 7:00 P.M.

Sincerely, Lena Guerrieri Principal

Page 11: Kendall Kaleidoscopekendall.ipsd.org/uploads/PTA/March_2012_Kaleidoscope.pdfKendall Kaleidoscope Page 3 2012 Jump Rope for Heart During our Valentine parties at Kendall, the 5th grade

11

INDIAN PRAIRIE SCHOOL DISTRICT #2042012-13 KINDERGARTEN PRE-REGISTRATION

Choose One Option: ALL DAY KINDERGARTEN HALF DAY KINDERGARTEN

Legal Student Name_________________________________________ Gender: Male or Female (first) (middle) (last)

Current Address_____________________________________________________________________________

Subdivision_____________________________________ Phone Number

(H)_______________________

Phone Number

(W)_______________________

Student Date of Birth___________________________________

Parent/Guardian Name_____________________________________________________________ (first) (last)

Did your child attend District 204’s Prairie Preschool? YES NO

Do you have other children at Kendall Elementary ? NO YES

List Name(s)______________________________

List Name(s)______________________________

Primary language spoken in the home_______________________

Health concerns, other services needed, or any additional information you wish to share:

PLEASE RETURN THIS FORM TO THE KENDALL OFFICE AS SOON AS POSSIBLE

Thank you!