GT/Horizons Mid‐year Testing: Parent Survey and Permission

Mid‐year Testing: Parent Survey and Permission

2021-2022 School Year
Campus: *
Student: *
Grade Level *
Homeroom Teacher: *
Student's Date of Birth: *

Month Day Year
Date
Parent Name: *
Read each numbered line of three characteristics, and CHECK THE ONE CHARACTERISTIC in each line that best describes your child.
1. *

rich elaboration advanced vocabulary meaningful expressions
2. *

masters information recalls information manipulates information
3. *

generalizes formulates compares/contrasts
4. *

questioning insightful indifferent
5. *

absorbed bored judgemental
6. *

demands acceptance demonstrates nonchalance critiques self
7. *

continues to develop with originality ventures into the unknown completes with accuracy
8. *

improvises manages absorbs
9. *

prefers convention takes risks adapts and modifies
10. *

interested in preferred topic concentrates intently invariably wants to know more
11. *

makes perfect grades not motivated by grades more concerned with learning than assessment
12. *

works at own pace strategizes plans
13. *

grasps principles over‐analyzes recognizes cause and effect
14. *

prefers concrete concepts thinks abstractly generalizes
15. *

reflective irrational curious
Read and check the following statements: *

I have checked one characteristic in each line to describe my child as it relates to his/her demonstrating gifted potential. By signing/entering my name below, I agree to have my child screened for the HORIZONS program. I understand that screening involves identification of student ability through testing, possibly interviewing the student, receiving teacher input, and/or collecting additional data to support gifted potential.
Parent Signature *

Clear
Date: *

Month Day Year
Date
Parent Email: *
Parent Phone Number: *
Office Use Only:
Grade: *
Should be Empty:

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