Recomendación para el Programa de Servicios Académicos Avanzados

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1 Recomendación para el Programa de Servicios Académicos Avanzados Este formulario debe ser devuelto antes de: 11 de diciembre de 2015 PERMISO de los padres y formulario de recomendación Fecha de hoy Nombre del niño Escuela Fecha de nacimiento Grado Maestro/asesor Masculino Femenino Idioma hablado en casa Lugar de nacimiento Nombre de los padres/apoderado legal Teléfono de casa Teléfono de trabajo Celular Dirección postal Código postal Correo electrónico Por favor notifique al Director del Programa de Servicios Académicos Avanzados/Estudiantes Altamente Capaces al si cambia de dirección postal. NO ACEPTAMOS NINGUNA RESPONSABILIDAD POR DEMORAS EN EL CORREO. Si el niño ha calificado para un programa de estudiantes altamente capaces en otro distrito escolar, por favor indicar lo siguiente: Distrito Ciudad Estado Autorizo para que mi hijo sea calificado para su elegibilidad de recibir servicios académicos avanzados. Firma del padre Fecha Además, autorizo para que mi hijo reciba servicios académicos avanzados (Si él/ella califica). Firma del padre Fecha Nominación / Proceso de recomendación: Los estudiantes de cualquier grado pueden ser nominados / recomendados para la evaluación de elegibilidad para recibir servicios académicos avanzados (de alta capacidad). Preselección/Proceso de evaluación: Todos los estudiantes del 2do grado serán preseleccionados usando la prueba CogAT. El resto de estudiantes que estén nominados / recomendados se pondrán a prueba en sus habilidades cognitivas (utilizando el CogAT-7) y sus logros académicos y (utilizando el ITBS). Criterios de selección / Indicadores: Los siguientes criterios son parte del proceso de evaluación usado para identificar a los estudiantes altamente capaces: Puntuación del 5% más alto en lectura y/o matemáticas. Puntuación del 10% más alto de la prueba de la capacidad cognitiva. Mostrar comportamientos excepcionales y las características identificadas en las escalas de calificación de padres y maestros. Proceso de selección: El comité de selección revisará los datos para determinar que alumnos cumplen los criterios de elegibilidad para recibir los servicios. El comité de selección quisiera tener la mayor cantidad de información posible para considerar la nominación de su hijo. 1. En qué áreas tiene su hijo ha demostrado un rendimiento académico significativamente por encima de sus compañeros? (por ejemplo: matemáticas, lectura)

2 Por favor complete el reverso PARENT Permission and Referral Form (cont.) 2. Describa brevemente con ejemplos específicos el comportamiento excepcional, características de aprendizaje, productos creativos y/o habilidades para resolver problemas que su hijo exhibe regularmente. 3. Incluya cualquier otra información que ayudará al comité de selección a entender el idioma o diferencias culturales o evidencia del bajo rendimiento académico el cual podría causar bajos resultados en las pruebas. (WAC ) Por favor complete este formulario y devuélvalo a la oficina de la escuela antes del 11 de diciembre de Proceso de Apelación: Si su hijo es nominado y evaluado, pero no cumple los requisitos, la decisión puede ser apelada mediante la presentación del formulario que se encuentra en la página web del distrito escolar. Si tiene alguna pregunta, por favor escribanos a: Gracias, Pam Farr Directora Ejecutiva de Enseñanza y Aprendizaje Distrito Escolar de Shelton 700 S. 1 st Street * Shelton, WA Revisado

3 Referral for Advanced Academic Program Services This form must be returned by: December 11, 2015 PARENT Permission And Referral Form Today s Date Child s name School Date of Birth Grade Teacher/Advisor Male Female Language spoken in home Birthplace Name of parent(s)/legal guardian(s) Home telephone Work telephone Cell Mailing address Zip Code Please notify the Program Director for Advanced Academics/Highly Capable Students at if your mailing address changes. WE CANNOT ACCEPT RESPONSIBILITY FOR DELAYS IN THE MAIL. If this child has qualified for a Highly Capable Program in another school district, please indicate the following: District City State I give permission for my child to be tested for eligibility to receive advanced academic services. Parent s signature Date In addition, I give permission for my child to receive advanced academic services (if he/she qualifies). Parent s signature Date Nomination/Referral Process: Students in any grade level can be nominated/referred for assessment for eligibility to receive advanced academic (highly capable) services. Screening/Testing Process: All 2 nd graders will be screened using the CogAT Screener. All other students who are nominated/referred will be tested on their cognitive abilities (utilizing the CogAT-7) and their academic achievements (utilizing the ITBS). Selection Criteria/Indicators: The following criteria are part of the assessment process used to identify highly capable students: Score in the top 5% in Reading and/or Math. Score in the top 10% of a cognitive ability test. Show exceptional behaviors and characteristics as identified on parent and teacher rating scales. Selection Process: Selection Committee will review data to determine students who meets the criteria for eligibility to receive services. The selection committee would like as much information as possible to consider your child s nomination. 4. What areas does your child demonstrate academic achievement significantly above their peers? (i.e., math, reading) Please complete reverse side

4 PARENT Permission and Referral Form (cont.) 5. Briefly describe specific examples of exceptional behavior, learning characteristics, creative products and/or problem solving abilities your child exhibits regularly. 6. Include any other information that will help the selection committee understand language or cultural differences or evidence of academic underachievement which might cause lower test scores. (WAC ) Please complete this form and return it to your school office by December 11, Appeals Process: If your child is nominated and assessed but does not qualify, the decision may be appealed by submitting the form located on the school district webpage. If you have any questions, please Thank You, Pam Farr Executive Director of Teaching and Learning Shelton School District 700 S. 1 st Street * Shelton, WA Revised

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