Gifted and Talented Referral/Permission to Test Form (Parent/Guardian)

Please complete the information below by April 30 so the assessment and evaluation can occur. Student ID is required to submit this form. If you do not know your student’s ID number, please contact his/her school. Referrals will only be accepted for Kindergarten through 11th grade. Pre-K referrals are not accepted at this time. Please note, parents must commit to bringing their child to all required testing dates. Testing will begin at 8:30 at a location to be determined and parents must be available by phone during testing as we will call when testing is completed. Parents will receive an email with more information regarding test location in May. • Students currently in kindergarten and 1st grade will test on June 1, 2, and 5. • Students currently in 2nd through 11th grade will test on June 1 and 2. As part of the assessment process, parents have the opportunity to provide information about their child by completing the Scales for Identifying Gifted Students (SIGS). A copy of the SIGS will be sent home to parents at the beginning of May. Students will be identified by June 21. Parents will receive notification via email. Please contact me if you have any questions. Tish Cawley Coordinator of Gifted and Talented Services 512-268-2141 x45035 tish.cawley@hayscisd.net

General Information

Student ID (numbers only)

Student First Name

Student Last Name

Student Campus

Grade

Date of Birth: (MM/DD/YYYY)

Homeroom Teacher (K-5) Last Name Only (If known)

Your relation to the student

Name of person submitting this form:

Phone number of person submitting this form:

Email of person submitting this form:

Parent/Guardian Permission For Assessment And Participation

ACCEPT: My typed name below represents my signature and confirms my permission for Hays Consolidated ISD to assess my child for gifted services and my committment to bringing my child to all assessment sessions on time. Additionally, if identified, my signature confirms permission for my child to participate in gifted services. More information about G/T services is available at www.hayscisd.net/gt.

DENY: My typed name below represents my signature and confirms that I deny permission for Hays Consolidated ISD to assess my child for possible G/T services. By completing this section, I am acknowledging my student will not be evaluated for G/T and therefore will not be eligible for services.

Parent/Guardian Signature:

Date:

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