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Gifted Education Teacher Observation /Referral Form
Please complete this form and return it to the Gifted Education Teacher in your building.  

Classroom teachers are critical in providing qualitative and quantitative data about a student's performance within the classroom.  As the curriculum experts, teachers can provide a body of evidence of students working above their same-age peers.  Evidence of exceptionality is above the 95th percentile while high abilities are below this level.  An example of this might be a sixth-grade student who has already demonstrated masterly of seventh and eighth-grade math standards and has successfully completed all the geometry modules from an online math program.  Advanced classroom performance must be measured through examples of above grade-level work.  Earning an "A" in a class does not necessarily indicate exceptional performance.  Grades lack standardization and are influenced significantly by students' motivation, classroom behavior, personal appearance, and study habits.  
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Email *
Student's School of Attendance   *
Student's Name:   *
Date of Referral: *
Teacher: *
Grade Level and School *
Please check the statement below that best describes this student, as relates to his or her ability (NOT academic performance):
Suspected area of giftedness (please check all that apply) Academic Areas:
Other Areas:  
Creative/Productive Thinking
Psychomotor Ability (athletics)
Performing Arts
Visual Arts
Leadership Ability
Other Areas
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