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GATE Testing Request Form 2018-2019
Please complete the following request form to initiate the GATE assessment process for your child. If your child is in a different grade, please contact your school counselor for other testing opportunities. Once this form is completed, your child will be tested at their school site. If your child misses the testing at the school site, we will email you information on testing dates at the district office.

Things to know:
The test is a one-on-one, approximately 30 minute, IQ test with the school psychologist.

We cannot provide any information on the test as we do not want the test to be compromised.
Acceptance/Regrets letters will be mailed to the address provided on this form.


Untitled Title
Student Information
Last Name *
First Name *
Date of Birth *
Name of Current School *
If your child is from out of district, please read below "NOTICE FOR OUT OF DISTRICT STUDENTS"
Required
From where you reside, what middle school is your home school? To check, click on this link: http://locator.decisioninsite.com/?StudyID=85023# *
Street Address *
Where you would like us to mail your GATE letter.
City *
State
Zip Code *
Current grade level *
Please note that our GATE program begins in the 6th grade.
Primary Language *
Does your child have an IEP? *
An IEP is an Individual Education Plan. This is generated for children that are in special education.
Does your child have a 504 Plan? *
A 504 Plan is generated if a child has a disability and requires accommodations.
Parent First and Last Name *
Parent Email Address *
Please make sure that your email address is accurate as this is the main form of communication.
Phone Number *
NOTICE FOR OUT OF DISTRICT STUDENTS:
Please note that we do not GATE test out of district students until our permits department receives:

1. Release from your current school district.
2. LVUSD permits application.
3. Necessary documents to enroll your child into our district.

Here is a link to our LVUSD Inter-district Incoming Students page: https://www.lvusd.org/incoming
An elaborate thinker, able to produce embellishments to an idea, situation, or problem and/or asks many questions to determine why or how things happen, what will happen next, or how things work *
An original thinker, able to see relationships among seemingly unrelated objectives, ideas or facts *
Is concerned with right and wrong, good and bad, fair and unfair *
Takes advantage of opportunities to learn; enjoys challenge and tasks which are not routine; is bored by routine tasks *
Is persistent in task completion; may be unwilling to change tasks or moves from task to task without regard for completion *
Is a leader, role model, trend setter in or out of school *
Has a keen awareness of the group process and may have the ability to manipulate others *
Is a high risk taker; adventurous and willing to deviate from standard procedures, answers, or behaviors; does not fear being different *
Generates a large number of ideas or solutions to problems and questions *
Is creative in finding ways to communicate and express ideas; (e.g., drawing, pantomime, body language, use of concrete objects, or other alternate means may replace limited facility with oral language) *
Displays maturity of judgment and decision-making beyond own age level *
Adapts readily to new situations; is flexible in thought and actions and is not disturbed when normal routine is changed *
Parent Release *
By selecting the "I Agree" checkbox below and submitting this form, you are acknowledging that you have reviewed the "Characteristics of Gifted Students" and are giving permission to Las Virgenes Unified School district to assess your student with a cognitive assessment to be administered by a Licensed LVUSD School Psychologist. The assessment results will NOT be placed in the student's cumulative file.
Required
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