Cloverdale Elementary School

1182 Merbach Dr., Carol Stream, IL 60188

(630) 588-5300

 

Kindergarten Families,

 

Welcome to Cloverdale School! We are excited to have your child join our kindergarten family and look forward to a wonderful year of learning and growth. As part of the kindergarten registration process, we invite you to complete the Ages & Stages Questionnaires (ASQ). This tool helps us learn more about your child's development and how we can best support their transition to kindergarten. You will complete two questionnaires: The ASQ-3 and the ASQ: SE- 2. This process can take 15 to 30 minutes and be paused if necessary. If it does not apply, you may skip the question “List others assisting with completion of the questionnaire.” When you click Submit on this page, you will be taken to another page to begin screening your child. If you have any questions or need assistance, please don’t hesitate to call (630) 588-5300. 

 

We can’t wait to meet your family and begin this exciting journey together!

 

Sincerely,

 

Keira Quintero, Principal

Child Date of Birth

Month Day Year

MM 01 02 03 04 05 06 07 08 09 10 11 12 DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 YYYY 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Child DOB you entered is in the future, are you sure of that? (Please correct the date before proceeding to the next step). Please enter your child's DOB and not the screening date or today's date (Please correct the date before proceeding to the next step). Child DOB you entered is not valid, please format the date like this: MM-DD-YYYY

Weeks Premature
(put "0" if not premature)

Screening Date Options

For ASQ-3™ English

Screening Date

Screening Date Selection

I am screening my child today (2025-12-07) I screened my child and am entering in the responses to a previous screening

Month Day Year

MM 01 02 03 04 05 06 07 08 09 10 11 12 DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 YYYY 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Please enter a valid screening date.

List others assisting with completion of the questionnaire

For ASQ:SE-2™ English

Screening Date I am screening my child today (2025-12-07) I screened my child and am entering in the responses to a previous screening

Month Day Year

MM 01 02 03 04 05 06 07 08 09 10 11 12 DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 YYYY 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Please enter a valid screening date.

List others assisting with completion of the questionnaire

I have read the provided information about the Ages & Stages questionnaires, and I wish to have my child participate in the online screening program. I will fill out the questionnaire about my child's development and promptly submit the completed questionnaire through this Family Access online questionnaire completion system.

Note: By clicking "Submit", you are agreeing to both our Family Access End User License Agreement and any other consent or authorization information outlined on this page.