University of Arkansas at Little Rock
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Online Teacher Recommendation
Teacher Recommendation
Student's Name
*
First
Last
Student's Current Grade Level
Kindergarten
First
Second
Third
Fourth
Fifth
Sixth
Seventh
Eighth
Teacher's Name
*
First
Last
Position
*
Classroom teacher, counselor, coach, etc)
School
*
(location where you know the child from)
District
*
Phone
*
Number you can be reached at if necessary.
Email
*
Preferably work email
Please rate the degree to which each characteristic describes the student:
Is able to succeed in an advanced course
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Is highly interested in the area of a course offered at SLUFY
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Scores at or above the 80th percentile on the achievement test
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Has scored at or above 120 on an intelligence test
Very Highly
Highly
Moderately
Slightly
Very Slightly
If this is unknown, you may skip the question
Has been accepted to a school gifted program
*
Yes
No
Being considered
Not offered
Is teacher-recommended for a program for high ability students
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Is able to analyze, syntehsize, and evaluate
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Is able to generate many alternatives
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Possesses unusual curiosity
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Is receptive to new tasks or experiences
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Uses creative written expression
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Uses creative oral expression
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Uses creative artistic expression
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Asks provocative questions
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Possesses a sense of humor
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Is open-minded
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Is a risk taker
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Is a keen observer
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Uses common sense
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Has a strong desire to learn
*
Very Highly
Highly
Moderately
Slightly
Very Slightly
Does the student currently participate in Gifted and Talented classes at your school?
*
Yes
No
Not Offered
I don't know
To assist in the screening process, please provide any additional information you believe will assist us. Additional information may also be provided by e-mailing the SLUFY team at giftedcenter@ualr.edu.
Would you like to be contacted regarding this application?
*
Yes
If necessary
Photocopy of standardized test (ITBS or similar) scores from the previous school year
Photocopy of school/district GT profile (if student participates in a GT program)
Photocopy of extraordinary school work (may substitute for the above documentation only if student is in kindergarten or if student is home schooled and in grades K-2)
Teacher Statement
*
I attest that the information included on this form and in this application package is accurate. I have reviewed student's selected courses, and I confirm that the student possesses interest and/or strength in that area.
