Leadership Teacher Referral Form
"Psychosocial or leadership ability" - possessing either potential or demonstrated ability to perform at an exceptionally high level in social skills and interpersonal qualities such as poise; effective oral and written expression; managerial ability and the ability or vision to set goals and organize others to successfully reach those goals.
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Student Name (First and Last) *
Grade *
Grade in which you taught this student: *
Person completing referral, your Name (First and Last) *
Indicate your level of recommendation for this student (Check one): *
Required
Leadership Checklist (Please mark all that apply to the student that you are referring for G&T Leadership) *
Required
Please describe the leadership strengths that this child has demonstrated compared to peers: *
Describe opportunities provided in the classroom or other environment to challenge, motivate, or further develop these leadership strengths: *
What one thing makes you feel strongly about the leadership qualities of this child? *
Does this student have any special considerations that may mask his/her G&T abilities? (Check all that apply.) *
Required
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