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* 1. What is the first and last name of the student you are referring for the Gifted and Talented evaluation process?

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* 2. What grade is the student in?

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* 3. What are the reasons you believe this student should be evaluated for G/T? (ex. grades, scores, etc.)

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* 4. Are you willing to participate in the identification process for the student you referred?

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* 5. If "yes" to question #4, please provide contact information as your assistance in the evaluation program may be essential.

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