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Referral Deadline: Friday, January 28, 2022 by 4:00pm PST
If your student qualifies, services will begin in the 2022-2023 school year.

Student First Name *
Student Last Name *
Student Date of Birth *
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Grade Level *
Please note: We DO NOT screen Preschool students.                                                                                                                                                                                                                  
School *
First Name of Person Making the Referral *
Last Name of Person Making the Referral *
Phone Number of Person Making the Referral *
Relationship to Student *
Questions or Concerns?
Please contact us at HiCapID@rentonschools.us

Phone: 425-204-2334

Address: 300 SW 7th St, Renton, WA 98057 (Kohlwes Education Center)
Permission to Test and Next Steps
Parents/Guardians - by submitting this form, you are giving the Renton School District Highly Capable Multi-Disciplinary Committee permission to review your student's academic and/or cognitive data to determine eligibility for Highly Capable services. While academic assessments are administered in class, the cognitive assessment, the Naglieri Nonverbal Ability Test, 3rd Edition (NNAT3), is only administered to students who are referred for Highly Capable screening. The student will take this test during the school day during Trimester 2; more information about this assessment will be sent to parents/guardians at the beginning of Trimester 2.

Teachers and Community Members - if you are the individual making this referral, please be sure to let the parent/guardian know that you have referred their student and that the district will be in contact with them for next steps. The parent/guardian will need to confirm via email that they indeed would like their student screened for Highly Capable services.

2nd graders: All 2nd graders will be screened for the Highly Capable program per school board policy. Submitting this form is not necessary if your student is in the 2nd grade.

The Committee's decision regarding Highly Capable program eligibility will be communicated to parents/guardians during the third trimester.
I have read and understand the above statement. *
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