REFERRAL/PERMISSION FORM FOR PARTICIPATION IN THE HIGHLY CAPABLE SCREENING PROCESS

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Email *

First and Last Name of Person Completing Form *

Student Name (Last) *

Student Name (First) *

Student's Skyward ID Number (7 Digits, usually starts with a 9) *

Student's Gender *

Female

Male

Gender X or Non-binary

Student's Date of Birth (Please verify year) *

YYYY

Teacher’s email address *

Parent/Guardian First and Last Name *

Parent/Guardian Address (Street Address, City, State, Zip Code) *

Parent/Guardian Contact Phone Number (area code and phone number) *

Parent/Guardian Email *

Student's Current Grade (K-2 & 5-7 Only for Fall) *

Student's Current School *

Boston Harbor

Centennial

Garfield

Hansen

Lincoln

LP Brown

Madison

McKenny

McLane

ORLA Montessori

Pioneer

Roosevelt

Jefferson Middle School

Marshall Middle School

Reeves Middle School

Washington Middle School

Avanti High School

Capital High School

Olympia High School

Olympia Regional Learning Academy (ORLA)

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