APS Gifted Services Referral Form
Please use the following form to refer an APS student whom you believe requires special provisions to meet her/his educational needs. The screening and referral process is ongoing. All referrals must be submitted to the school principal or Resource Teacher for the Gifted (RTG) no later than April 1 of the current school year.  Referrals received after April 1 will be considered in the next school year.

Padres o tutores legales: Por favor, completen este formulario para iniciar el proceso de elegibilidad para recibir Servicios  para alumnos dotados. Todas las remisiones deberán ser dirigidas al director de la escuela o el Maestro de Recursos (RTG) para  alumnos dotados a más tardar el 1° de abril del corriente año escolar. Las remisiones recibidas después del 1 de abril se tomarán en cuenta el siguiente año escolar.
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Email *
Student's Last Name 
Apellido nombre del estudiante
*
Student's First Name
Primer nombre del estudiante
*
Student ID
Número de identificación del estudiante
Grade Level
Grado
*
Who is referring this student for gifted services?
¿Quién efectúa la remisión de este estudiante para  recibir Servicios para Alumnos Dotados? 
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Today's Date 
Fecha de la remisión
*
MM
/
DD
/
YYYY
Electronic Signature (Type your full name)
Firma (Escriba su nombre)
*

APS identifies learners within the school population who demonstrate or have the potential to demonstrate exceptional aptitude and talent in specific academic areas (English, mathematics, science, and/or social students) in grades K-12 and/or visual and performing arts (visual arts and general music) in grades 3-12.

In my judgment, this student has abilities, talents, and potential for accomplishment in the following area(s): (Check all that apply)

En mi opinión, este estudiante tiene las habilidades, talentos, y el potencial para realizar logros que requieren condiciones especiales para satisfacer sus necesidades académicas en las áreas siguientes:

*
Required
Any other notes for consideration? 
¿Alguna otra nota?
A copy of your responses will be emailed to the address you provided.
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