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Inspire 2023 Application
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Email
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Student's Name
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Date of Birth
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Name of Person Completing This Form
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Relationship to student
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Contact email of person completing form
This is used to confirm that the information provided by you is accurate and correct
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Current Primary School:
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Part A
Please read the following descriptions, and the examples given to help you understand each item, carefully. Mark your perception/experience on the scale from Strongly Agree (1) to Strongly Disagree (5). Fill in one circle for each item. If you are unclear or have not noticed how your child compares to others please leave blank. (Please do not feel pressured to comment in every section.) Specific examples are helpful for each item and space is provided each time.
1. Has quick recall of information…(e.g. immediately remembers facts, series of numbers, events, words of songs etc)
Strongly Agree
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5
Strongly Disagree
Clear selection
Personal example
Your answer
2. Has a high level of acquired knowledge about specific areas ………….. (e.g. music, sports, electronics etc)
Strongly Agree
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5
Strongly Disagree
Clear selection
Personal example
Your answer
3.Uses advanced vocabulary....(surprises others with big words, knows exact terms etc)
Strongly Agree
1
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5
Strongly Disagree
Clear selection
Personal example
Your answer
4. Reads particularly well and attempts difficult reading tasks.
Strongly Agree
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5
Strongly DIsagree
Clear selection
Personal Example
Your answer
5. Shows intense interest and enjoyment when learning about new things.
Strongly Agree
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5
Strongly Disagree
Clear selection
Personal Example
Your answer
6. Is persistent and commits to completing tasks.
Strongly Agree
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5
Strongly Disagree
Clear selection
A personal example
Your answer
7. Has a great interest in the future and/or world problems.
Strongly Agree
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5
Strongly Disagree
Clear selection
Your answer
8. Is prepared to take social and mental risks.
Strongly Agree
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5
Strongly Disagree
Clear selection
Personal Example
Your answer
9. Puts unrelated ideas together in new and different ways.
Strongly Agree
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5
Strongly Disagree
Clear selection
Personal Example
Your answer
10. Asks reasons why –questions almost everything?
Strongly Agree
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5
Strongly Disagree
Clear selection
Personal Example
Your answer
Part B
Current and/or previous gifted and talented aspects. Please comment (where appropriate) on any of the following:
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Has your child ever been part of a program for gifted and talented children? If so please give details.
Your answer
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Special talents, unusual accomplishments, present and past.
Your answer
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Achievements in National and International Competitions (English, Mathematics, Chess etc)
Your answer
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Ability to play a musical instrument or instruments. Which instrument(s)?
Your answer
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At what age did your child begin to read independently?
Your answer
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Describe any hobbies, collections, or strong interests that your child may have had? e.g interest in art, handicrafts, reptiles, theatre, magic tricks, writing, poetry or collections?
Your answer
If you would like to comment further on your child, please do so below. Thank you for your time.
Your answer
With thanks - Dr. John Chisholm and Ms. Mel Timpson - Gifted and Talented Liaison Officers
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