SOUTHWEST LICKING ELEMENTARY TEACHER

GIFTED AND TALENTED NOMINATION CHECKLIST

Nominated Student ______Part I: Learning Characteristics

1 / 2 / 3 / 4
1. Has unusually advanced vocabulary for age or grade level
2. Possesses a large storehouse of information about a variety of topics (beyond the usual interest of youngsters his or her age)
3. Has quick mastery and recall of factual information
4. Has rapid insight into cause-effect relationships
5. Tries to discover the how and why of things
6. Asks many provocative questions (as distinct from information or factual questions)
7. Has a ready grasp of underlying principles and can quickly make valid generalizations about events, people, or things
8. Is a keen and alert observer
9. Usually "sees more" or "gets more" out of a story, film, etc. than others
10. Reads a great deal on his or her own
11. Reasons things out for him/her self
COLUMN TOTAL
WEIGHT / x1 / x2 / x3 / x4
WEIGHTED COLUMN TOTAL
TOTAL SCORE

Date______Building ______

Grade______Nominated by ______

Please circle the appropriate answer below.

WHAT IS THE STUDENT'S AREA(S) OF STRENGTH?

superior cognitive ability (generally high intelligence)

math, reading, language, science, social studies

WHAT IN PARTICULAR STANDS OUT ABOUT THIS STUDENT?

______

______

______

______

______

DIRECTIONS FOR COMPLETING THE CHECKLIST

Using this scale rate the student on characteristics described in each area:

1-seldom or never
2-occasionally
3-considerably
4-almost always

Note that the numeral at the top of each grid corresponds to the above rating scale. Place a checkmark in the grid column that most accurately reflects how well the student fulfills each statement.

**This checklist is meant to help you thoughtfully consider the nomination of a potentially gifted child. This score will not be used to determine gifted identification.

SOUTHWEST LICKING ELEMENTARY TEACHER

GIFTED AND TALENTED NOMINATION CHECKLIST

Part II: Motivational CharacteristicsPart III: Creativity Characteristics

1 / 2 / 3 / 4
1. Becomes absorbed and truly involved in certain topics or problems (It is sometimes difficult to get him or her to move on to another topic.)
2. Is easily bored with routine tasks
3. Needs little external motivation to follow through in work that initially excites him or her
4. Strives toward perfection
5. Is self critical and is not easily satisfied with his or her own speed or products
6. Prefers to work independently
7. Is interested in many "adult" problems such as religion, politics, sex, race, war - more than usual for age level
8. Often is self-assertive (sometimes even aggressive)
9. Often introverted, but thinks deeply.
10. Is quite concerned with right and wrong, good and bad
11. Often evaluates and passes judgment on events, people, and things
COLUMN TOTAL
WEIGHT / x1 / x2 / x3 / x4
WEIGHTED COLUMN TOTAL
TOTAL SCORE
1 / 2 / 3 / 4
1. Displays a great deal of curiosity about many things
2. Is constantly asking questions about anything and everything
3. Generates a large number of ideas or solutions to problems and questions
4. Often offers unusual "way out," unique, clever responses
5. Is sometimes radical and spirited in disagreement
6. Often concerned with adapting, improving, and modifying institutions, objects, and systems
7. Displays a great deal of intellectual playfulness, fantasizes, imagines (I wonder what would happen if...)
8. Displays a keen sense of humor
9. Shows emotional sensitivity
10. Is sensitive to beauty
11. Is nonconforming, individualistic
12. Is not interested in details
13. Accepts disorder
COLUMN TOTAL
WEIGHT / x1 / x2 / x3 / x4
WEIGHTED COLUMN TOTAL
TOTAL SCORE

SOUTHWEST LICKING ELEMENTARY PARENT

GIFTED AND TALENTED NOMINATION CHECKLIST

Nominated Student ______Part I: Learning Characteristics

1 / 2 / 3 / 4
1. Has unusually advanced vocabulary for age or grade level
2. Possesses a large storehouse of information about a variety of topics (beyond the usual interest of youngsters his or her age)
3. Has quick mastery and recall of factual information
4. Usually has a deeper understanding and gets more out of a book or visual presentation
5. Tries to discover the how and why of things
6. Asks many provocative questions (as distinct from information or factual questions)
7. Has rapid insight into cause & effect relationships
8. Learns math processes and concepts quickly
9. Puts unrelated ideas together in a new way or order
10. Reads a great deal on his or her own and does not avoid difficult material
11. Reasons things out for him/her self; sees logical and common sense answers independently
12. Sees humor in situations that may not be humorous to others; is playful with words
13. Shows positive leadership qualities
COLUMN TOTAL
WEIGHT / x1 / x2 / x3 / x4
WEIGHTED COLUMN TOTAL
TOTAL SCORE

Date______Building ______

Grade______Nominated by ______

Please circle the appropriate answer below.

WHAT IS THE STUDENT'S AREA(S) OF STRENGTH?

superior cognitive ability (generally high intelligence)

math, reading, language, science, social studies

WHAT IN PARTICULAR STANDS OUT ABOUT THIS STUDENT?

______

______

______

______

______

DIRECTIONS FOR COMPLETING THE CHECKLIST

Using this scale rate the student on characteristics described in each area:

1-seldom or never
2-occasionally
3-considerably
4-almost always

Note that the numeral at the top of each grid corresponds to the above rating scale. Place a checkmark in the grid column that most accurately reflects how well the student fulfills each statement.

**This checklist is meant to help you thoughtfully consider the nomination of a potentially gifted child. This score will not be used to determine gifted identification.

SOUTHWEST LICKING ELEMENTARY PARENT

GIFTED AND TALENTED NOMINATION CHECKLIST

Part II: Motivational CharacteristicsPart III: Creativity Characteristics

1 / 2 / 3 / 4
1. Becomes absorbed and truly involved in certain topics or problems (It is sometimes difficult to get him or her to move on to another topic.)
2. Is easily bored with routine tasks
3. Needs little external motivation to follow through in work that initially excites him or her
4. Strives toward perfection
5. Is self critical and is not easily satisfied with his or her own speed or products
6. Prefers to work independently
7. Is interested in many "adult" problems such as religion, politics, sex, race, war - more than usual for age level
8. Often is self-assertive (sometimes even aggressive)
9. Often introverted, but thinks deeply.
10. Is quite concerned with right and wrong, good and bad
11. Often evaluates and passes judgment on events, people, and things
COLUMN TOTAL
WEIGHT / x1 / x2 / x3 / x4
WEIGHTED COLUMN TOTAL
TOTAL SCORE
1 / 2 / 3 / 4
1. Displays a great deal of curiosity about many things
2. Is constantly asking questions about anything and everything
3. Generates a large number of ideas or solutions to problems and questions
4. Often offers unusual "way out," unique, clever responses
5. Is uninhibited in expressing opinions
6. Often concerned with adapting, improving, and modifying institutions, objects, and systems
7. Displays a great deal of intellectual playfulness, fantasizes, imagines (I wonder what would happen if...)
8. Displays a keen sense of humor
9. Shows emotional sensitivity
10. Is sensitive to beauty and aesthetics often unnoticed by others
11. Is nonconforming, individualistic
12. Accepts disorder
13. Is unwilling to accept authoritarian pronouncement without critical examination
COLUMN TOTAL
WEIGHT / x1 / x2 / x3 / x4
WEIGHTED COLUMN TOTAL
TOTAL SCORE

SOUTHWEST LICKING ELEMENTARY STUDENT

GIFTED AND TALENTED NOMINATION FORM

Nominated Student ______

Date______Building ______

Grade______Nominated by ______

Please circle the appropriate answer below.

WHAT IS THE STUDENT'S AREA(S) OF STRENGTH?

superior cognitive ability (generally high intelligence, problem solving, creativity)

mathreading/languagesciencesocial studies

WHAT IN PARTICULAR STANDS OUT ABOUT THIS STUDENT?

______

______

______

______

______

**Please return this form to the gifted intervention specialist in your school.