LISD Kindergarten GT Referral                                  ECC
It is the policy of Lindale Independent School District not to discriminate on the basis of race, color, national origin, sex or handicap in any programs, services or activities as required by Title VI of the Civil Rights Act of 1964, as amended; Title IX of the Education Amendments of 1972; and Section 504 of the Rehabilitation Act of 1973, as amended. For information about your rights or grievance procedures, contact Jamie Holder, Deputy Superintendent, 505 Pierce Street, Lindale, Texas 75771
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Student First Name *
Student's Last Name *
Student's Homeroom Teacher *
Student ID # *
Student lunch # or library # (if you do not have this, you can look in Skyward Family Access, ask the homeroom teacher or front office)
Student's Birth Date *
MM
/
DD
/
YYYY
Parent/Guardian Names *
Student's Mailing Address *
Street Address or P.O.Box
Student's Mailing Address *
City, State, Zip Code
Student's Home Phone
Cell Phone Number
Parent/Guardian E-Mail
Name of Person Referring Student *
Relationship to Student *
Academic Areas You Feel Student Exhibits Giftedness *
Required
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