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Inspire 2017 Application
Student's Name
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Date of Birth
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Person Completing This Form
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Parent email
This is used to confirm that the information provided by you is accurate and correct
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Current Primary School:
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Part A - Please • Read carefully the following descriptions. The examples given should help to understand each item. • Mark your perception/experience on the scale from Strongly Agree (SA) (1) to Strongly Disagree (SD) (5). • Fill in one circle for each item. • If you are unclear or have not noticed how your child compares to others please leave blank. (Please do not feel pressured to comment in every section.) • Specific examples will be helpful.
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1. Has quick recall of information…(e.g. immediately remembers facts, series of numbers, events, words of songs etc) *
Strongly Agree
Strongly Disagree
Personal example
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2. Knows a great deal about ………….. (e.g. music, sports, electronics etc) *
Strongly Agree
Strongly Disagree
Personal example
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3.Uses advanced vocabulary....(surprises others with big words, knows exact terms etc)
Strongly Agree
Strongly Disagree
Personal example
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4. Reads particularly well and attempts difficult reading tasks. *
Strongly Agree
Strongly DIsagree
Personal Example
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5. Shows intense interest and enjoyment when learning about new things.
Strongly Agree
Strongly Disagree
Personal Example
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6. Is persistent and sticks to tasks.
Strongly Disagree
Strongly Agree
A personal example
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7. Has a great interest in the future and/or world problems.
Strongly Disagree
Strongly Agree
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8. Is prepared to take social and mental risks.
Strongly Disagree
Strongly Agree
Personal Example
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9. Puts unrelated ideas together in new and different ways.
Strongly Disagrees
Strongly Agrees
Personal Example
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10. Asks reasons why –questions almost everything?
Strongly Disagrees
Strongly Agrees
Personal Example
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Part B - Identifying Gifted and Talented Children – Parent Identification Form Please comment (where appropriate) on any of the following:
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• Has your child ever been part of a program for gifted and talented children? If so please give details.
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• Special talents, unusual accomplishments, present and past.
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• Achievements in National and International Competitions (English, Mathematics, Chess etc)
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• Ability to play a musical instrument or instruments. Which instrument(s)?
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• At what age did you child begin to read independently?
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• Describe any hobbies, collections, or strong interests that you child may have had? E.g interest in art, handcrafts, reptiles, theatre, magic tricks, writing poetry or collections?
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If you would like to comment further on your child, please do so below. Thank you for your time.
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Dr. John Chisholm - Gifted and Talented Liaison Officer
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