Academic Acceleration for Advanced Learners
Referral Form

Student Name: ________________________________	 Grade: _____	Date of Birth: ______________
School: ______________________________________
Parent Name: _________________________________
Address: _____________________________________________________________________________
Phone Number: _____________________	Email Address: __________________________________

Type of Acceleration Requested:
☐ Early Entrance to Kindergarten (School Year: _______________)
☐ Single Subject Acceleration (School Year: _______________) (select one)
	☐ Mathematics	☐ Language Arts	☐ Social Studies	☐ Science
☐ Whole Grade Acceleration (School Year: _______________)
	From Grade _____ to Grade _____
☐ Early Graduation (Current Graduation Year: __________)
	Proposed Graduation Year: __________
Referred by:
	☐ Self	☐ Parent	☐ Student	☐ Teacher	☐ Counselor	☐ Principal
	☐ Other ___________________________

I have reviewed the considerations for academic acceleration, and believe my child would benefit from this service.  I request evaluation for my child for possible academic acceleration and grant consent for the school or its authorized representative permission to assess my child.

___________________________________	____________________
Parent / Guardian Signature	Date

The referral request will be processed and parents will receive the final determination for academic acceleration within ninety (90) days from the date the referral is received.

___________________________________	____________________
Signature of Person Receiving Referral	Date

Understanding the Types of Academic Acceleration

Single subject acceleration is when a student is placed in another grade level for instruction in only a specific subject area (e.g. math or language arts).  In some cases, your child may have to travel to a different building to receive accelerated instruction in a particular subject area.

Whole grade acceleration is when a student is placed in a higher grade full-time, and will attend all classes (e.g. math, language arts, science, and social studies) in the accelerated grade level.  In some cases, this may mean that your child will begin attending a new building at an earlier age.

Early graduation means that the child will make arrangements to complete all graduation requirements at least one year prior to his or her previously determined graduation year.  It is important to note that in cases of students graduating early, all state-mandated graduation requirements, including standardized testing requirements, must be met in order for the student to graduate early.

Considerations for Academic Acceleration

When considering whether or not a child will be a good candidate for academic acceleration, the child should:

•	Clearly demonstrate consistent high ability in one or more subject areas
•	Clearly demonstrate accelerated performance in one or more subject areas when compared to his or her grade- or age-mates
•	Have a Full Scale IQ (FSIQ) or cognitive score at least one standard deviation above the mean (typically 115 or higher)
•	Have no or minimal concerns in regards to social and/or emotional adjustment
•	Consistently score in the Advanced range on state achievement tests, if applicable
•	Have no siblings in the proposed accelerated grade level or siblings who are at least two or more grades above or below the child
•	Have good school attendance
•	Have a positive attitude, neither over-estimating or under-estimating his/her ability
•	Complete assignments with care
•	Be motivated to do well
•	Enjoy challenges
•	Be physically comparable in size with other students in the proposed grade level
•	Demonstrate appropriate interpersonal skills with peers and adults for his/her age
•	Have parental support, with parents who are not overly involved in his/her education
•	Have the support of several people (i.e. classroom teacher, gifted intervention specialist, parents, principal, counselor) who know the student is pursuing academic acceleration
•	Have no issues with time management (i.e. balance of extracurricular activities)
•	Feel he/she clearly needs acceleration; it should not simply be a “want”
•	Have a support system in place to fill possible learning gaps
•	Demonstrate a high level of mastery of concepts not yet introduced in the subject(s) under consideration for acceleration (in the case of whole grade acceleration, this would be all subject areas – i.e. math, reading, science, social studies)