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Highly Capable Testing Referral Form

Welcome to the SVSD Highly Capable Testing Referral Form.  Please complete a form for each student you are referring.   The referral form window is open from Nov. 6 - Jan. 5. at 4 p.m.

Please note, a referral does not guarantee testing. A body of evidence will be reviewed for each submission to determine if further testing is appropriate. Highly capable testing will occur during the school day. Please see dates below.

Grades Required Testing Date(s)
1st - 4th Grades March 8 & March 15
5th March 8
6th & 7th March 8

If you want to learn more about our process, please view our Highly Capable webpage. For specific questions about the process of or you have difficulty completing the online form, please contact our Teaching and Learning team. 

Highly Capable Referral Form

Required

STUDENT INFORMATION
Student Namerequired
First Name
Last Name
Genderrequired
Must contain a date in M/D/YYYY format
PARENT/GUARDIAN INFORMATION
Namerequired
First Name
Last Name
Preferred Communication Methodrequired
Please indicate if your student is currently receiving special services.Check all that apply or leave blank
Check all that apply or leave blank
Is there a documented need for testing accommodations for this student? requiredIf yes, we will contact you to gather additional information.
If yes, we will contact you to gather additional information.
Has the student taken the Cognitive Abilities Test (CogAT) or ITBS in the past year? required
Attach up to 1 file with a maximum size of 20MB
No file chosen
If the answer to the previous question was "yes," please attach the testing data.

PARENT-RATING SCALE

General Intellectual Ability

Please fill out the score for your student. 
 
1 - Never
2 - Rarely
3 - Some
4 - More
5 - Much More
Has excellent reasoning ability.required
Establishes cause-effect relationships.required
Can analyze an issue from many points of view.required
Is able to reach good conclusions based on evidence.required
Is curious and seeks answers to questions.required
Is an excellent planner and decision maker.required
Gathers information to make sense of a situation.required
Demonstrates a healthy skepticism and curiosity.required
Asks complex questions about a topic.required
Is able to rapidly understand novel tasks.required
Is able to figure out what is needed to solve a problem.required
Can easily relate new information to old information.required

Creativity

Please fill out the score for your student. 
 
1 - Never
2 - Rarely
3 - Some
4 - More
5 - Much More
Seeks to create rather than imitate.required
Is persistent in finding solutions to problems.required
Is proficient at problem-finding.required
Enjoys taking risks (e.g., doesn’t mind consequences of being different, not afraid to try something new).required
Breaks gender stereotypes.required
Does not mind uncertainty.required
Enjoys time alone (particularly when engaged in the creative process).required
Is an excellent improviser.required
Has a passionate interest or talent (e.g., art, poetry, creative writing or science).required
Is attracted to the complex and unique.required
Likes adventure; is energetic.required
Values own creativity.required
Parent/Guardian ConsentrequiredI permit SVSD to test my child to determine eligibility or possible placement in gifted program(s).
I permit SVSD to test my child to determine eligibility or possible placement in gifted program(s).