GT Identification Referral Form
This form should be completed for students who are ONLY seeking GT identification for an Advanced Learning Plan (ALP), and who are planning to remain at their current neighborhood, option or charter school, and NOT planning to attend a GT Center school.

The ID process could take several weeks to complete. Parents will be notified via email regarding GT identification and/or the creation of an ALP.

COMPLETION OF THIS FORM IN NO WAY GUARANTEES THAT AN IDENTIFICATION WILL BE MADE. After the form is submitted, an identification process will begin which will include a body of evidence (BOE) review for your student. During the process, further information and testing may be required for your student. At the end of the process a status/determination will be made by a data review team regarding identification. If at anytime during this process you have questions, please reach out to your school's Gifted & Talented Resource Teacher. The 2018-19 GT Resource Teacher assignments: https://www.jeffcopublicschools.org/UserFiles/Servers/Server_627881/File/Jeffco%20PS/Programs/Gifted%20and%20Talented/2018-19%20GT%20Resource%20Teacher%20and%20Building%20Leader%20by%20School%20-%20Sheet1%20(1)%20(1).pdf

Please complete the Parent Narrative form in addition to this form for GT identification. The Parent Narrative can be found
https://docs.google.com/forms/d/e/1FAIpQLSerLsh0MGk8z9wuNHVAlOfOyJwKTgMYkiQORwqYjobfl_6cow/viewform

The district supports the use of electronic communication by staff. Security of district computer systems is a high priority however; the district cannot guarantee the confidentiality of email communication. Requests to prohibit email communication regarding among other things, ALP application, data or testing information should be sent to: GT Department, 1829 Denver West Drive. #27, Golden, CO. 80401.

Email address *
I have read the above statement regarding Notice of Referral *
Personal Identification Information (PII) Request and Information
It is Jeffco Schools policy to receive permission from parents before emailing anything with PII. Throughout the referral/identification process, the GT Department may need to communicate and/or send documents to you that contain PII. Please read and respond to the required question below regarding PII:
I give permission for the GT Department to communicate personal identification information (PII) through electronic communications (email). *
What Jeffco school does your student attend? *
Student First Name *
Your answer
Student Last Name *
Your answer
Middle Name *
Your answer
Current Jeffco Student *
Jeffco Student ID *
Your answer
Birthdate (mm/dd/yyyy) *
MM
/
DD
/
YYYY
Gender *
Current Grade *
Parent/Guardian Name *
Your answer
Parent/Guardian Email *
Your answer
Parent/Guardian Contact Phone Number *
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Current Teachers Name (if known)
Your answer
Does your child receive IEP/504 testing accommodations?
If you have additional data for your student, please email it to gtinform@jeffco.k12.co.us.
Your answer
Has your child been identified in another Disctrict
Submit
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