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

PLEASE COMPLETE THE INFORMATION BELOW BY OCTOBER 31ST. 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. Students will be identified by March 1st. Parents will receive notification via email. Please visit the Hays CISD Gifted and Talented website at www.hayscisd.net/gt for more information.

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 indication here and typed name below represents my signature and confirms my permission for Hays Consolidated ISD to assess my child for gifted services and my commitment 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.

Parent/Guardian Signature:

Date:

Parent Questionnaire

Instructions: Please make a selection that best describes your child for each item below. • Almost Always • Occasionally • Seldom Your responses will aide the committee in the identification process.

Does your child have an advanced vocabulary?

Does he/she want to know how things work or why people say or do certain things?

Does your child notice likenesses and differences between people, events, or things?

Is your child a keen and alert observer?

Does your child suggest a better way to do something if he/she isn’t satisfied with the way it’s being done?

Is your child extremely curious? Does he/she ask many questions about different topics?

Does your child think through his/her decisions more than most children of the same age?

Does your child seem to look for challenges?

Is there additional information you would like to provide regarding the way your child thinks and/or learns?

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