GATE Screener Opt Out Form
Dear Parents,

David M Cox Elementary School is administering an ability test to screen second grade students for gifted programming. We request that your child participate in taking the Naglieri Nonverbal Ability Test (NNAT3). This test is a brief, culturally unbiased, nonverbal measure of general ability. This is a group test that will be administered by the school GATE specialist.

Participation is voluntary. Your child’s grades and/or progress in school will not be affected in any way by participating.

Please complete the bottom portion of this form to withhold your child from participation in this screening.


Anissa Cole
David M Cox ES
GATE Specialist
ONLY complete this form if you DO NOT wish to have your child assessed. All other students will automatically be assessed and no additional work is necessary on your behalf. *
Child’s Name: *
Home Phone Number: *
Teacher’s Name: *
Parent’s Signature (Type full name to represent signature) *
Date *
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