Grades 4-12 Referral "Specific Academic Aptitude"
Student: *
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School: *
Grade: *
Date: *
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Teacher or Guardian Making Referral: *
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Does student have:
Indicate your level of recommendation for this student: (check one)
Area(s) of Strength - Please note you MUST fill out the corresponding checklist(s) below. *
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Specific Academic Aptitude means possessing either potential or demonstrated ability to perform at an exceptionally high level in specific academic area(s) significantly beyond the age, experiences, or environment of one's chronological peers. Please describe the academic strengths that this student has demonstrated in the classroom. Provide specific examples for each area that you are referring or see strengths. *
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What things have been done in the classroom to challenge, motivate, or further develop these academic strengths? *
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If you are referring this student for the area of Language Arts, please fill out the checkboxes below.
If you are referring this student for the area of Math, please fill out the checkboxes below.
If you are referring this student for the area of Science, please fill out the checkboxes below.
If you are referring this student for the area of Social Studies, please fill out the checkboxes below.
Does this child have any special considerations that may mask his/her GT abilities? (check all that apply)
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