Rowan County School District
Elementary Gifted Program
Parental Response Form
Student ________________________________ Age __________ Grade ___________
Parent/Guardian ________________________________________ Date ____________
Parents have the right to nominate their child or children for the Gifted/Talented Program in
Rowan County Public Schools. Your nomination can be one of the three items required for
placement in the Primary Talent Pool at grades K – 3, or one of the four required items
needed at grades 4 – 12. If you wish to nominate your child for gifted services, please
respond to the two items below and then fill out the survey on the next two pages as
completely as possible.
What skills or interests does your child exhibit that you feel are exceptional or unusual?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
If you think your child possesses unusual skills and ability in any one or more of the five (5)
areas of giftedness listed below, please check the area(s) which you believe apply to him/her.
1. _____ Intellectual skills
2. _____ Academic skills in
_____ Math
_____ Language Arts
_____ Science
_____ Social Studies
3. _____ Creative thinking
4. _____ Leadership skills
5. _____ Visual and Performing Arts (music, art, dance, drama)
____________________________________
(signature of parent or guardian)
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Rowan County School District
Elementary Gifted Program
Parental Response Form
Student’s Name: ___________________________________
Grade: _______________
Person Completing Form: _________________________________________
Relationship to student: __________________________________________
Please check in the appropriate column below for each item as it relates to your child.
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Possesses large and varied vocabulary and uses it meaningfully
Knows a lot of information about many topics
Asks many questions that involve complex answers
Makes generalizations easily
Has a keen sense of humor
Loves to read, particularly books of a more mature level
Tries to reason things out independently
Becomes bored with routine
Prefers to work alone
Becomes interested in “adult” problems
Assertive and sometimes stubborn about beliefs
Generates many ideas/solutions to problems
Willing to take risks
Sensitive to the aesthetic (artistic/visual aspects of things)
Does not fear being different; is a non-conformist
Adapts easily to new situations
Excels in areas outside the regular school curriculum
Recalls facts easily
Wants to know how things work
Asks “why” or questions everything
Likes “grown-up” things and likes to be with older people
Is adventurous
Is persistent; sticks to a task
Is independent and self-sufficient
Becomes immersed in topics of self-interest
Is sensitive to the feelings of others
Likes to role-play
Please answer the questions on the next page to complete this form.
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Rowan County School District
Elementary Gifted Program
Parental Response Form
Student’s Name: ___________________________________
1. My child spends the greatest amount of his/her time:
2. My child’s interests/hobbies/collections include:
3. My child’s favorite books to read are:
4. My child displays special talents/skills in the following areas:
5. Activities my child enjoys participating in when not at school:
6. Any additional information that you feel will help us to better understand your child:
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