GT Teacher Nomination Form
Email *
Teacher Name *
Last Name, First Name
Please select your subject *
Student Last Name *
Student First Name *
Student ID Number(REQUIRED- can be found in eschool) *
Who initiated the referral?
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HOPE Nomination Scale
When rating students on each item below please think about the student compared to other children similar in age, experience, and/or environment.

Use the following scale to indicate how frequently you observe the 11 traits and behaviors listed below.

6=Always 5=Almost Always 4=Often 3=Sometimes 2=Rarely 1=Never    
Academic *
6
5
4
3
2
1
Performs or shows potential for performing at remarkably high levels
Is eager to explore new concepts
Exhibits intellectual intensity
Uses alternative processes
Thinks "outside the box"
Has intense interests
Social *
6
5
4
3
2
1
Is sensitive to larger or deeper issues of human concern
Is self-aware
Shows compassion for others
Is a leader within his/her group of peers
Effectively interacts with adults or older students
Please indicate all content areas where the student shows talent.
Check all that apply.
Please provide additional information concerning this child's potential: (Do NOT use the child's name) *
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