4th grade Highly Capable Services Parent/Guardian/Community Member Referral Form
Complete this form to refer your child for Highly Capable Services.
The online referral window will be open from Thursday, February 11, 2021, and will close on Monday, February 22, 2021, at 5:00 pm.
After the referral window closes on Monday, February 22, 2021, you will be notified and provided information about your child's assigned testing date and time. All students will be assigned a virtual test session during the weeks of March 8-19th. Parent permission is required for your child to test.
After testing has been completed, an eligibility committee will meet to determine students' eligibility for Highly Capable Services. Eligibility decisions will be made by early May. Eligibility letters will be mailed in May to your home address that is listed in Skyward. Parent/guardian permission is required for services to begin in the 21-22 school year. Parents/guardians may choose to accept or decline services.
If you have any questions, please contact Katie Coder, the K-12 Advanced Learning Programs TOSA, at 360.279.5037 or
Student's First Name
Student's Last Name
Broad View Elementary
Crescent Harbor Elementary
Oak Harbor Elementary
Olympic View Elementary
Current Classroom Teacher
Does this student receive accommodations or modifications to the regular education program?
Yes, the student has a 504 plan.
Yes, this student has a special education plan (such as an IEP).
Yes, this student receives ELL services.
No, this student does not receive any accomodations or modifications.
Is your child currently receiving Highly Capable Services?
Yes, my child is currently receiving Highly Capable Services at Oak Harbor Public Schools.
The person completing this referral has the following relationship to the student being referred:
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This form was created inside of Oak Harbor School District.