Enter child's name exactly how it appears on the birth certificate.​
City/State​​
(or Parent/Guardian's)​​​​
(or Parent/Guardian's)​​


(check all that apply)​​




Before we can process this intake information, we need to see proof of residency in one of the parent/guardian's names. This can be a utility bill (water, electric, trash, cable) or a rental/lease agreement showing the current date within the past 30 days and the 'service address'. If the utility bills are not in your name you will need to fill out an Affidavit of Residency. Once you fill it out, have it notarized and give that to us with a utility bill in the name of the person that signed the affidavit for you.

Please email Lisa Young your proof of residency. If you are unable to provide sufficient proof of residency, please email Lisa Young for the Affidavit of Residency.

mailto:lisa.young@rentonschools.us


We will need you to bring us a copy of your child's birth certificate and immunization records at the time of the screening.

At the end of the 30-minute screening held here at Meadow Crest, you will be informed if your child is 'typically developing and within normal limits' OR you and your child will be invited back for additional special education evaluation activities.

If you have any questions, please email mailto:lisa.young@rentonschools.us or call (425) 204-2205.


Please provide an email address where we can send a link to your current form.

Email Address :