Candler County Schools Program for the Gifted Parent/Peer/Self Referral
The purpose of this nomination is to determine a student's need for gifted services. To nominate a student for consideration for gifted program placement, please provide the information requested below. The information will then be reviewed by the Gifted Eligibility Review Team to determine evaluation status.
Student's First Name *
Student's Last Name *
Student's Middle Initial *
Student's Date of Birth *
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/
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Student's School *
Student's Homeroom Teacher *
Student's Grade Level *
Student's Gender *
Student's Ethnicity *
Student's Race *
Parent's Name *
Address *
Phone Number *
Person Making Referral *
Relationship to Student *
My child is an intense learner. This is demonstrated through
For each statement, choose the word that best describes your child.
determination to complete assignments and projects successfully. *
using advanced vocabulary, incorporating it into conversation or writing. *
possessing a large amount of factual knowledge used accurately, reading extensively. *
social awareness, concerns for fairness, prejudice, and equity issues beyond age level. *
exploring topics of personal interest beyond age level, becoming totally absorbed in an area of particular interest. *
Please cite specific examples from above.
My child is an analytical thinker. Analytical thinking is demonstrated through
For each statement, check the word that best describes your child.
an understanding of ideas and complex concepts. *
an interest in challenging situations, approaching problems from different perspectives, tackling difficult problems and issues which others may find frustrating. *
learning new skills and concepts quickly. *
an awareness of relationships, using metaphors or analogies, making mental connections. *
a willingness to take risks, showing confidence in answers and willing to support a different idea or opinion. *
Please cite specific examples from above.
My child is a creative producer. Creative, productive thinking is demonstrated through
For each statement, check the word that best describes your child.
generating different ideas, adapting readily to new situations. *
originality, expressing familiar ideas in unusual ways, offering unique solutions to problems or questions, creating original products. *
creating detailed projects, turning the simple into complex, adding details, embellishing. *
questioning, asking complex questions not typical of age group. *
a sense of humor reflecting advanced understanding, seeing humor in situations others find humorless. *
Please cite specific examples from above.
My child is highly motivated in areas of interest. Motivation is demonstrated through
For each statement, check the word that best describes your child.
working well independently. *
exceeding expectations, doing more than what is required on assignments of interest. *
working cooperatively as a team member, receptive to the ideas of others. *
eagerness to complete assignments of interest on time or prior to due date. *
assuming leadership positions, leading the group. *
Please cite specific example from above.
Additional Comments
Please be as specific as possible in commenting on any characteristics, abilities, and/or aptitudes of your child that you feel should be brought to the attention of the Gifted Review Team. Also attach any work samples, awards, certificates, honors, special recognition your child has received that will demonstrate his/her exceptionalities.
Please include additional comments.
Please upload any work samples, awards, certificates, honors, etc...
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