Kaleidoscope Family Information Form
PARENTS:  By completing this form, you are indicating that you would like your student considered for gifted programming services for the 2024-2025 school year

Please complete no later than May 24, 2024.  
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Student Name *
Date of Birth *
MM
/
DD
/
YYYY
Parent/Guardian Name(s) *
Home Mailing Address *
Email Address (in case of questions) *
School *
Has your student been previously identified to receive gifted services?   *
Is your student currently participating in Pinwheel or another gifted program? *
Ratings
Please rate your student as honestly as possible.  The committee is most interested in any examples you may be able to provide.  This gives us extra insight into them, their interests and their capabilities.  
Section 1:  My student is an intense learner.  This is demonstrated through... *
Seldom or Never
Occassionally
Considerably
Almost Always
determination to complete assignments and projects
using advanced vocabulary, incorporating it into conversation or writing
possessing a large amount of factual knowledge and reading extensively
social awareness, concern for fairness, prejudice and equity issues beyond age group
exploring topics of personal interest and becoming totally absorbed in an area of particular interest
Section 1 Examples:
Section 2:  My student is an analytical thinker.  This is demonstrated through... *
Seldom or Never
Occassionally
Considerably
Almost Always
an understanding of ideas and complex concepts
an interest in challenging situations, approaching problems from different perspectives, tackling difficult problems which others may find frustrating
learning new skills and concepts quickly
an awareness of relationships, using metaphors and analogies, making mental connections
a willingness to take risks, showing confidence in answers and willing to support a different idea or opinion
Section 2 Examples:  
Section 3:  My student is a creative producer.  This is demonstrated through... *
Seldom or Never
Occassionally
Considerably
Almost Always
generating different ideas, readily adapting to new situations
originality, expressing familiar ideas in unusual ways, offering unique solutions to problems and questions, creating original products
creating detailed projects, turning the simple into complex, adding details, embellishing
questioning, asking complex questions not typical of age group
a sense of humor reflecting advanced understanding
Section 3 Examples:  
Section 4:  My student is highly motivated in areas of interest.  This is demonstrated through... *
Seldom or Never
Occassionally
Considerably
Almost Always
working well independently
exceeding expectations, doing more than what is required on assignments of interest
working cooperatively as a team member, receptive to the ideas of others
eagerness to complete assignments of interest prior to the due date
assuming leadership positions
Section 4 Examples:  
Optional - What else would you like us to know about your student?  
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