Harriet Bishop Gifted and Talented Elementary School Admissions

Teacher Nomination Form 2016-2017

(Please print)

Applicant's nameGrade applying for:

Current District/SchoolCurrent grade:

Teacher completing form:Date:

Teacher's Signature:Telephone:

How long have you known the applicant?In what capacity?

Harriet Bishop Gifted and TalentedElementary School is a magnet school in ISD 191 Burnsville-Eagan-Savage dedicated to the education of intellectually gifted students. The school is designed to meet the academic and social-emotional needs of gifted learners in a full-time gifted environment. The above student's family is considering an application to Harriet Bishop and we require a Teacher Nomination as part of the evaluation process for each applicant.

Please read the following statements carefully and indicate the degree to which you agree or disagree with each one as it pertains to the applicant. At the end of the first set of statements, there is a brief section asking you to rate the child on a handful of traits. Finally, there is a very important section of open-ended questions about this student. Please complete all sections as completely and honestly as possible. All your answers will be kept strictly confidential.

StronglyDisagree NeutralAgreeStrongly

DisagreeAgree

1. The student is intensely curious about many things.12345

2. The student is individualistic or nonconformist.12345

3. The student has an amazing ability to recall facts12345

and events.

4. The student is sometimes easily frustrated by others.12345

5. The student is able to transfer ideas to new situations.12345

6. The student is aware of connections or possibilities that12345

others do not see.

7. The student uses unique and unusual ways of solving12345

problems.

8. The student is perfectionist and sets high standards.12345

9. The student has intense feelings and opinions.12345

10.The student is passionate about sharing his/her ideas.12345

11.The student brings an immense level of energy and focus12345

to tasks that interest him/her.

12.The student often leads and directs activities for peers.12345

13.The student shares his/her opinions freely and eloquently.12345

14.The student has a keen sense of humor.12345

15.The student uses an advanced vocabulary for his/her age.12345

16.The student has a vivid imagination and enjoys creative12345

play.

17.The student adds intricate details to stories or pictures12345

he/she creates.

18.The student can often get others to do what he/she wants.12345

19.The student quickly and easily masters new concepts and12345

information.

20.The student has frustration with written tasks.12345

21.The student asks provocative questions about causes 12345

and effects.

22.The student is/was an early reader or avid reader.12345

23.The student is interested in conversing or interacting12345

with older children and adults.

24.The student shows a heightened concern for moral issues,12345

concern for others, or things being "fair".

25.The student has learned many things without being12345

formally taught.

How would you rate this student compared to others of the same age or grade level?

Far below BelowAverageAboveFar above

Average AverageAverageAverage

26. Self-confidence12345

27. Self-direction12345

28.Respect for others12345

29.Self-discipline12345

30.General maturity12345

The following are open-ended questions. Please feel free to answer on a separate page, if you wish, and attach to this recommendation form.

1. How would you describe this child as a learner?

2. Do you think this student will adapt well to and thrive in a full-time gifted environment?

3. What else would you like us to know about this student?

When complete, please mail or fax this form directly to:

Erika Nesvig, Principal

ISD 191 Burnsville-Eagan-Savage, HarrietBishopG/TElementary School

14400 O'Connell Road

Savage, MN 55378

Phone: 952-707-3900

Fax: 952-707-3902