School Component Form

About our program: Academy for Gifted and Talented Youth is a two-week enrichment program for gifted, talented and/or high achieving students who have completed grades K-8. Your recommendation helps us to assess a student's potential for success in this program. Please complete this form in a timely fashion and return it to the parent to be submitted as part of the registration packet.

All fields required unless indicated otherwise.

Student Information

Student Assessment

  1. Is or has the applicant ever been involved in a gifted and talented program in the school district?

    YesNoThere is no formal gifted program in our district.

  2. We strive for the best possible match of student to course. In what subject areas does this child show strength?

  3. Please assess the child's performance/potential for participation in the three-hour classes held over a two-week, Mon-Fri. period.

  4. Has this student ever been sent to the principal or vice principal’s office for behavior-related issues?
  5. Please check what applies:
    Area Average Above Average Superior Other (Explain)
  6. The Student Is: Never Rarely Sometimes Often Always
    Kind and Considerate to Others never rarely sometimes often always
    Respectful never rarely sometimes often always
    Motivated to complete tasks given never rarely sometimes often always
    Follows instruction never rarely sometimes often always
    Shows high level of creativity never rarely sometimes often always
    Able to focus on the task at hand never rarely sometimes often always

What other information about this student should the Excursions in Learning Program consider?