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Ouachita Public School G/T Program Referral
In considering this student as a participant in the program for gifted students, please choose the appropriate number for each item.
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Student *
Birthdate *
Age *
School *
Grade *
Referred by *
Parent(s) name(s) *
Mailing Address *
Home/ Work Phone *
1. Has superior communication skills- has unusually advanced vocabulary for his/her age or grade.
Rarely Notice
Notice Often
Clear selection
2. Learns rapidly and easily.
Rarely Notice
Notice Often
Clear selection
3. Is intensely interested in one or more topics.
Rarely Notice
Notice Often
Clear selection
4. Is a keen and alert observer.
Rarely Notice
Notice Often
Clear selection
5. Is original- uses good but unusual methods on tasks.
Rarely Notice
Notice Often
Clear selection
6. Likes to organize and bring structure to things.
Rarely Notice
Notice Often
Clear selection
7. Displays superior abstract thinking skills.
Rarely Notice
Notice Often
Clear selection
8. Notices discrepancies easily.
Rarely Notice
Notice Often
Clear selection
9. Displays a great deal of curiosity about many things.
Rarely Notice
Notice Often
Clear selection
10. Is creative.
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Notice Often
Clear selection
11. Is a conscientious worker.
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Notice Often
Clear selection
12. Reads a great deal on his/her own.
Rarely Notice
Notice Often
Clear selection
13. Looks above and beyond what is required.
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Notice Often
Clear selection
14. Words independently; requires little direction from teacher.
Rarely Notice
Notice Often
Clear selection
15. Shows interest in his/her own achievement.
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Notice Often
Clear selection
16. Makes good use of class time.
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Notice Often
Clear selection
17. Works well with other members of his/her class.
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Notice Often
Clear selection
18. Handles responsibility well.
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Notice Often
Clear selection
Any additional information on this student will be beneficial in the referral process..
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