Application form - University of Louisiana at Lafayette

Center for Gifted Education
P.O. Box 43251
Lafayette, LA 70504-3251
(337) 482-6701
Fax: (337) 482-1073
Université des Acadiens
2015 Center for Gifted Education
Children’s Programs Assessment Application Form
The Center for Gifted Education is excited to announce its 2015 Children’s Programs. There will be three different
programs: Academic Enrichment for Pre-K and Kindergarten (have not entered Kindergarten), Academic Enrichment for
rising 1st-6th grades, and Summer Scholars for rising 7th – 10th grades.
In order to participate in this program, a student must qualify by screening at UL Lafayette or by presenting documentation
of qualifying intelligence or achievement test scores from an approved outside source. Eligible students are accepted for
the various program components and courses on a first-come, first-served basis. Previous participants maintain eligibility.
Possible Documentation:
Evidence of qualification for a parish gifted program;
Or
Intelligence test scores at or above the 90th national percentile, or qualifying scores on standardized tests of
academic achievement (i.e., at least one advanced score in ELA or Math), including SAT or ACT;
Or
Assessment at the Center for Gifted Education: To have your child assessed, go to http://ullcge.appointy.com/
or call Brenda Trahan at (337) 482-1963 to schedule your child’s assessment after you have mailed your form.
If you have test scores that meet the above requirements, please send a copy with your application and
include your check for $50 for the application fee to the address listed below.
AND
RECOMMENDATION (TO BE COMPLETED BY PARENT/GUARDIAN or TEACHER/COUNSELOR/ADMINSTRATOR)
Current School (if in a school)
Referring Parent/Guardian or Teacher
For PreK/K students, please attach a short recommendation stating why you are referring the student.*
You may have noticed distinguishable differences from age peers in the following areas: reading ability, sense of humor,
curiosity, attention, and movement. They may have the ability to make abstract connections, demonstrate advanced
perceptiveness. Include any information explaining why the student would benefit from the program.
For 1st – 9th grade students, please have a teacher/counselor/administrator complete a recommendation at goo.gl/psyReN
A Member of the University of Louisiana System
Center for Gifted Education
P.O. Box 43251
Lafayette, LA 70504-3251
(337) 482-6701
Fax: (337) 482-1073
Université des Acadiens
APPLICATION SECTION: TO BE COMPLETED BY PARENT/GUARDIAN- $50 Screening/Application Fee Required
with Form
Child’s Full Name
Sex: ____ M ____ F
Grade in 2014-15
Parent/Guardian(s)*
Date of Birth_______
Home Phone #:
Mailing Address
Street Address/Box No.
City
State
Zip
Parish of Residence
Parent(s)/Guardian’s Daytime Phone Numbers:*
Parent/Guardian
Parent/Guardian
*Single-parent families should list only the parent who is legally responsible for this child.
Parents’ E-mail Addresses
Parent/Guardian
Parent/Guardian
Return completed application and $50 testing/admission fee to: Center for Gifted Education, P O Box 43251,
Lafayette, LA 70504-3251
Please make checks payable to UL Lafayette and write your child’s name in the memo section of the check.
PLEASE NOTE: We do not accept cash or credit cards.
2015 PRE-K/K ACADEMIC ENRICHMENT PROGRAM INFORMATION
Preschool classes, for children ages 4 (by June 5) to 5 years of age, are designed to engage and nurture students’
developing strengths in language arts, number sense, problem solving, and the arts.
DATES: JUNE 8-11, 2015 AND JUNE 15-18, 2015 (M-TH morning & afternoon options available)
SITE: EARLY CHILDHOOD LAB NEXT TO THE PICARD CENTER (OFF DEVALCOURT ST)
A Member of the University of Louisiana System
Center for Gifted Education
P.O. Box 43251
Lafayette, LA 70504-3251
(337) 482-6701
Fax: (337) 482-1073
Université des Acadiens
2015 ACADEMIC ENRICHMENT SUMMER PROGRAM INFORMATION
The Academic Enrichment Program is a Summer Enrichment Program that will engage 1st – 6th graders in deep exploration
of a topic area, where they will learn the skills of professionals, and develop products based on their topic area. Classes will
last for three hours and during the two weeks there will be two concurrent parent sessions.
DATES: June 8-11 & June 15-18, 2015 (Monday through Thursday)
TIME: 1-4 PM; SITE: UL-Lafayette Campus
2015 SUMMER SCHOLARS AND COMMUTER PROGRAM INFORMATION
The Summer Scholars Program is a Sunday – Friday residential and commuter program designed to develop the
academic, leadership, and/or creative skills of entering 7th, 8th, 9th, 10th grade students who have demonstrated high levels
of ability in their school work, in the arts, or in their daily lives. The program is hosted and sponsored by the Center for
Gifted Education at the University of Louisiana at Lafayette.
DATES: JUNE 21-26, 2015; SITE: UL-Lafayette Campus
Watch website: www.louisiana.edu/giftededucation and our Facebook page
https://www.facebook.com/center4giftedULL for more details!!
*Assessment (i.e., gifted identification, standardized test scores, Center for Gifted Education assessment) must
be completed prior to program enrollment. To apply, please submit the application form along with copies of
test scores, and your check or money order for the $50 application fee.
A Member of the University of Louisiana System