Highly Capable (HiCap) Program
18560 1st Avenue NE
Shoreline, WA 98155
(206) 393-4771
HICAP STUDENT PLACEMENT TEACHER PERCEPTION FORM
Dear Teacher: The student below is applying for placement in the Shoreline Public Schools Highly Capable program. In
selecting students for the program we consider several factors, including teacher perceptions. Teacher perceptions are
just one of several pieces of information considered. No one piece will determine if the student is accepted. If you are
willing to provide your perceptions of this student, please use this form to describe the characteristics of this student, then
return it directly to the Shoreline HiCap program office: by fax 206-393-4219, by mail at the address above, or e-mail to
[email protected]. Thank you.
XXX
Student Name:
School:
XXX
Teacher Signature:
Grade:
X
Date:
Teacher Name:
(Please Print Clearly)
TEACHER PERCEPTION OF STUDENT CHARACTERISTICSi
Directions:
Please read the statements below carefully and describe student according to the following list. Provide only one check
mark per question that best reflects your student.
LEARNING CHARACTERISTICS
The student demonstrates . . .
NEVER
VERY
RARELY
RARELY
SOMETIMES
FREQUENTLY
ALWAYS
NEVER
VERY
RARELY
RARELY
SOMETIMES
FREQUENTLY
ALWAYS
1. advanced vocabulary for his or her grade level
2. the ability to make generalizations about events, people, and
things.
3. a large storehouse of information about a specific topic.
4. the ability to grasp underlying principles.
5. interest in many “adult” topics, such as religion, politics, race, and
ethics.
6. insight into cause and effect relationships.
7. an understanding of complicated material through analytical
reasoning ability.
8. a large storehouse of information about a variety of topics.
9. the ability to deal with abstractions.
10. recall of factual information.
11. keen and insightful observations.
12. the ability to state and define goals and priorities of others even
when they are not the same as his or her own.
13. the ability to transfer learnings from one situation to another.
CREATIVITY CHARACTERISTICS
The student demonstrates . . .
14. imaginative thinking ability.
15. a sense of humor.
16. the ability to come up with unusual, unique, or clever responses.
17. sensitivity to beauty and the aesthetic characteristics of things.
18. an adventurous spirit or a willingness to take risks.
19. the ability to generate a large number of ideas or solutions to
problems or questions.
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Highly Capable (HiCap) Program
18560 1st Avenue NE
Shoreline, WA 98155
(206) 393-4771
CREATIVITY CHARACTERISTICS, CONTINUED
The student demonstrates . . .
NEVER
VERY
RARELY
RARELY
SOMETIMES
FREQUENTLY
ALWAYS
NEVER
VERY
RARELY
RARELY
SOMETIMES
FREQUENTLY
ALWAYS
NEVER
VERY
RARELY
RARELY
SOMETIMES
FREQUENTLY
ALWAYS
20. a tendency to see humor in situations that may not appear to be
humorous to others.
21. the ability to adapt, improve, or modify objects or ideas.
22. the ability to generate ideas that fall into different categories.
23. intellectual playfulness, willingness to fantasize and manipulate
ideas.
24. a non-conforming attitude, does not fear being different.
MOTIVATION CHARACTERISTICS
The student demonstrates . . .
25. the ability to concentrate intently on a topic for a long period of
time.
26. behavior that requires little direction from teachers.
27. sustained interest in certain topics or problems.
28. tenacity for finding out information on topics of interest.
29. persistent work on tasks even when setbacks occur.
30. a preference for situations in which he or she can take personal
responsibility for the outcomes of his or her efforts.
31. follow-through behavior when interested in a topic or problems.
32. intense involvement in certain topics or problems.
33. a commitment to long term projects when interested in a project.
34. persistence when pursuing goals.
35. little need for external motivation to follow through in work that is
initially exciting.
LEADERSHIP CHARACTERISTICS
The student demonstrates . . .
36. responsible behavior, can be counted on to follow through on
activities/projects.
37. a tendency to be respected by classmates.
38. the ability to articulate ideas and communicate well with others.
39. self-confidence when interacting with age peers.
40. the ability to organize and bring structure to things, people, and
situations.
41. cooperative behavior when working with others.
42. a tendency to direct an activity when he or she is involved with
others.
43. verbal behavior characterized by “richness” of expression,
elaboration, and fluency.
Other Comments (feel free to write more than the space provides, just be sure to attach that sheet to this document):
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Highly Capable (HiCap) Program
18560 1st Avenue NE
Shoreline, WA 98155
(206) 393-4771
i
Renzulli, J. S., Smith, L. H., White, A. J., Callahan, C. M., Hartman, R. K., & Westberg, K. L. (2002). Scales for rating the behavioral characteristics of superior students: Technical and administration
manual. Revised edition. Mansfield Center, CT: Creative Learning Press.
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