1-12 Gifted and Talented Services Parent/Staff Referral Form  2023-2024
FILL OUT THIS FORM AS COMPLETELY AS POSSIBLE TO PROVIDE INFORMATION ABOUT YOUR CHILD.  

Per Board Policy EHBB(LOCAL), reassessment shall occur no more than once in elementary grades, once in middle school grades, and once in high school grades. 

Please have access to your child's Student ID (lunch number) before proceeding.  It can be found on your child's progress report or report card.  

ANY ERRORS SUBMITTED IN THIS FORM WILL INVALIDATE THE REFERRAL.

Your email address is also required so you may receive a receipt after submitting this form.

If your child qualifies for services, this form gives PTISD permission to provide GT services.

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Email *
Name of the person referring the student. *
Select your role in the student's life. *
Your phone number *
Student's Last Name *
Student's Legal First Name *
Student ID Number (5-digit number) *
Grade *
Name of the student's teacher *
Has a vivid imagination *
Rarely
Always
Shows a strong desire to learn *
Rarley
Always
Demonstrate highly developed curiosity. *
Rarely
Always
Asks endless questions: has desire to know more. *
Rarely
Always
Uses advanced or extensive vocabulary. *
Rarely
Always
Has unusual or advanced sense of humor. *
Rarely
Always
Is very sensitive toward self and/or others. *
Rarely
Always
Is passionate about certain interests/topics *
Rarely
Always
Please use this space to provide any additional information you would like the placement committee to consider. *
I am the parent/guardian of the nominated student and grant permission for Gifted and Talented testing by Pine Tree ISD. *
A copy of your responses will be emailed to the address you provided.
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