Acceleration Request

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When advanced learning opportunities (enrichment and extensions) are not sufficient in meeting a student's academic needs, a parent/guardian, teacher, student or staff member may request to accelerate a student to a grade higher than their age group by filling out this form. The Advanced Academic Coordinator will follow up with these requests and communicate next steps.

What is the full name of the person who is requesting acceleration for a student? *

What is the requester's email address?

What is the requester's relationship to the student? *

Parent or Guardian

Classroom Teacher

Self (Student is making the request)

Staff member in Roseville Area Schools

Other

What is the student's first and last name? *

What school does the student currently attend? *

What is the current grade level of the student? *

What is the name of the student's classroom teacher?

What type of acceleration is requested? *

Grade Acceleration (all subjects; full grade advancement)

Subject Acceleration (one content area such as math)

Unsure which acceleration is more appropriate; considering both options at this time

If you are requesting subject acceleration, which subject area (for example, math) is in need of advancement?

Please state the reasons for this acceleration request. Why might this student be a good candidate for acceleration? *

Does this student actively seek and persist in new and rigorous academic challenges? *

Yes, always or almost always

Yes, often

Sometimes or is inconsistent

Rarely

No, never or almost never

Does this student complete most assignments more quickly and more comprehensively than other classmates? *

Yes, always or almost always

Yes, often

Sometimes or is inconsistent

Rarely

No, never or almost never

I don't know

Does this student show a positive and realistic self-concept? *

Yes, always or almost always

Yes, often

Sometimes or is inconsistent

Rarely

No, never or almost never

Does this student thoughtfully consider feedback and criticism, and modify behavior appropriately? *

Yes, always or almost always

Yes, often

Sometimes or is inconsistent

Rarely

No, never or almost never

Does this student show positive and effective behavior? *

Yes, always or almost always

Yes, often

Sometimes or is inconsistent

Rarely

No, never or almost never

Does this student have good interpersonal skills with age-mates and older students? *

Yes, always or almost always

Yes, often

Sometimes or is inconsistent

Rarely

No, never or almost never

Does this student have positive relationsips with teachers? *

Yes, always or almost always

Yes, often

Sometimes or is inconsistent

Rarely

No, never or almost never

I don't know

Please note any concerns you have about the student's social, emotional and/or behavioral functioning.

CLASSROOM TEACHER ONLY: Please indicate the type of interventions that have been used to address the student's advanced needs

Increased depth/complexity of work with extensions or enrichment

Pre-testing and compacting the curriculum (eliminating mastered material)

Tiered assignments (offering grade-level assignments and advanced assignments)

Independent study or project based learning

Increased pace of learning

Other:

Clear selection

CLASSROOM TEACHER ONLY: Describe how the interventions checked above were not successful in fully meeting the student's advanced needs.

Do you have anything else you would like to share regarding this student's advanced needs?

Do you have any questions?

If you would like a phone call to discuss any questions you have after submitting this form, please leave the phone number you would like us to call and the time of day that is best for you.

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