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SGES K-2 Gifted Referral 19-20
Before completing the form, please review the following websites:
https://drive.google.com/file/d/1F8L3nmrE4ykRapMSXJZLCIslSjyY80n7/view
https://drive.google.com/file/d/19xE9DCOi9p-bLDkV02iw_4agWNtiX636/view
https://drive.google.com/file/d/11He1RiSWbW_SHX8n-3aWi4ZaMrLyU9tm/view
Please complete the following questions if you wish to have your student evaluated for gifted services at SGES.
If you have any questions, please reach out to Mrs. Guidry (
ejguidry@henrico.k12.va.us
) or Ms. Kelly (
cekelly@henrico.k12.va.us
).
**Please make a note to check your student's backpack carefully during the week of January 27. An additional form will be sent home during this week.**
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Email
*
Your email
Student Grade
*
Choose
K
1
2
Student's Teacher
*
Choose
Lynn (K)
Arthur (K)
Brady (K)
Foley (K)
Sherman (K)
Daniels (1)
Gaugler (1)
Graves (1)
Harrell (1)
Luke (2)
Goddin (2)
J. Jones (2)
LaFlame (2)
Sanborn (2)
Student Last Name
*
Your answer
Student First Name
*
Your answer
Area of Referral (If your student is already identified in one area, please choose the other area. For example, if your student is IDed in language, you would choose math only.)
*
Choose
General Intellect (Language and Math--choose this option if you would like your student evaluated for services in both areas.)
Language Only (Choose this option if you would like your student evaluated for services in Language only OR if your student is already identified in math.)
Math Only (Choose this option if you would like your student evaluated for services in Math only OR if your student is already identified in language.)
Name of Person Making Referral
*
Your answer
Relationship of Person Making Referral to Student
*
Choose
Parent/Guardian
Teacher
Community Member
Self
I have read and reviewed the links at the top.
*
Choose
Yes
No
Please visit the link below to complete and send in the Parent Questionnaire. This MUST be sent as a SIGNED hard copy. Emailed copies will not be accepted. If you need a hard copy, please choose the response below. Hard copies will be sent home via student backpack the week of Jan. 27.
https://drive.google.com/file/d/1K5iK_P_9dtTgGBHz5s-6uijZohZVIHQI/view
*
I will complete and send in a hard copy of this form.
I will need a hard copy of this form sent home to me via my student's backpack. (Will be done the week of Jan 27.)
A copy of your responses will be emailed to the address you provided.
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