Gifted Institute Recommendation | gifted.carroll.edu

Applicant/Camper

Student First Name *

Student Last Name *

School Personnel

Reference First Name *

Reference Last Name *

Reference Email *

School Name *

School Street Address *

School City *

School State *

School Zip Code *

How long and it what capacity have you known the student? *

Place an (√) in the space opposite each description that best characterizes the student. *

	Excellent	Good	Fair	Poor	Unsure
cooperates with authority *	cooperates with authority - Excellent	cooperates with authority - Good	cooperates with authority - Fair	cooperates with authority - Poor	cooperates with authority - Unsure
cooperates with peers *	cooperates with peers - Excellent	cooperates with peers - Good	cooperates with peers - Fair	cooperates with peers - Poor	cooperates with peers - Unsure
demonstrates leadership *	demonstrates leadership - Excellent	demonstrates leadership - Good	demonstrates leadership - Fair	demonstrates leadership - Poor	demonstrates leadership - Unsure
projects self-confidence *	projects self-confidence - Excellent	projects self-confidence - Good	projects self-confidence - Fair	projects self-confidence - Poor	projects self-confidence - Unsure
articulates ideas and communicates well with others *	articulates ideas and communicates well with others - Excellent	articulates ideas and communicates well with others - Good	articulates ideas and communicates well with others - Fair	articulates ideas and communicates well with others - Poor	articulates ideas and communicates well with others - Unsure
demonstrates an advanced vocabulary *	demonstrates an advanced vocabulary - Excellent	demonstrates an advanced vocabulary - Good	demonstrates an advanced vocabulary - Fair	demonstrates an advanced vocabulary - Poor	demonstrates an advanced vocabulary - Unsure
demonstrates logical & mathematical reasoning *	demonstrates logical & mathematical reasoning - Excellent	demonstrates logical & mathematical reasoning - Good	demonstrates logical & mathematical reasoning - Fair	demonstrates logical & mathematical reasoning - Poor	demonstrates logical & mathematical reasoning - Unsure
demonstrates visual & spatial reasoning (i.e., puzzles) *	demonstrates visual & spatial reasoning (i.e., puzzles) - Excellent	demonstrates visual & spatial reasoning (i.e., puzzles) - Good	demonstrates visual & spatial reasoning (i.e., puzzles) - Fair	demonstrates visual & spatial reasoning (i.e., puzzles) - Poor	demonstrates visual & spatial reasoning (i.e., puzzles) - Unsure
demonstrates technology skills *	demonstrates technology skills - Excellent	demonstrates technology skills - Good	demonstrates technology skills - Fair	demonstrates technology skills - Poor	demonstrates technology skills - Unsure
demonstrates musical ability *	demonstrates musical ability - Excellent	demonstrates musical ability - Good	demonstrates musical ability - Fair	demonstrates musical ability - Poor	demonstrates musical ability - Unsure
demonstrates dramatic ability (i.e., imitates others, creates plays) *	demonstrates dramatic ability (i.e., imitates others, creates plays) - Excellent	demonstrates dramatic ability (i.e., imitates others, creates plays) - Good	demonstrates dramatic ability (i.e., imitates others, creates plays) - Fair	demonstrates dramatic ability (i.e., imitates others, creates plays) - Poor	demonstrates dramatic ability (i.e., imitates others, creates plays) - Unsure
makes and executes plans to accomplish goals *	makes and executes plans to accomplish goals - Excellent	makes and executes plans to accomplish goals - Good	makes and executes plans to accomplish goals - Fair	makes and executes plans to accomplish goals - Poor	makes and executes plans to accomplish goals - Unsure
pursues challenging goals to completion *	pursues challenging goals to completion - Excellent	pursues challenging goals to completion - Good	pursues challenging goals to completion - Fair	pursues challenging goals to completion - Poor	pursues challenging goals to completion - Unsure
demonstrates creative problem solving *	demonstrates creative problem solving - Excellent	demonstrates creative problem solving - Good	demonstrates creative problem solving - Fair	demonstrates creative problem solving - Poor	demonstrates creative problem solving - Unsure
demonstrates imagination *	demonstrates imagination - Excellent	demonstrates imagination - Good	demonstrates imagination - Fair	demonstrates imagination - Poor	demonstrates imagination - Unsure
demonstrates interpersonal skills (self-aware) *	demonstrates interpersonal skills (self-aware) - Excellent	demonstrates interpersonal skills (self-aware) - Good	demonstrates interpersonal skills (self-aware) - Fair	demonstrates interpersonal skills (self-aware) - Poor	demonstrates interpersonal skills (self-aware) - Unsure
demonstrates sensitivity to feelings & motives of others *	demonstrates sensitivity to feelings & motives of others - Excellent	demonstrates sensitivity to feelings & motives of others - Good	demonstrates sensitivity to feelings & motives of others - Fair	demonstrates sensitivity to feelings & motives of others - Poor	demonstrates sensitivity to feelings & motives of others - Unsure
has advanced academic potential *	has advanced academic potential - Excellent	has advanced academic potential - Good	has advanced academic potential - Fair	has advanced academic potential - Poor	has advanced academic potential - Unsure
demonstrates advanced academic performance *	demonstrates advanced academic performance - Excellent	demonstrates advanced academic performance - Good	demonstrates advanced academic performance - Fair	demonstrates advanced academic performance - Poor	demonstrates advanced academic performance - Unsure

What are this student’s greatest strengths? *

What are this student’s weaknesses? *

Recommendation *

* Please check one option

I recommend this student for the Gifted Institute.

I recommend this student for the Gifted Institute with reservations.

I do not recommend this student for the Gifted Institute.

Please make any additional remarks that you feel would be valuable.

Terms of Acceptance
I, the referrer, have read and understand the information provided in this recommendation.

Reference Signature

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Signer Name

* I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance. *

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