The Midland Academy of Advanced and Creative Studies

Parent Nomination Form
Grades K-3

Parent Identification Matrix
Person Completing this Form:
Date:
Student Name:
Age:
Directions: This scale is to be returned to The Midland Academy upon registration, which occurs after a
child has been selected from the Lottery. The items are derived from the research literature dealing with
characteristics of academically superior and creative persons. It should be pointed out that a
considerable amount of individual differences can be found within this population; and therefore, the
profiles are likely to vary a great deal. Please mark the column that most describes your child in
comparison to the typical child in your neighborhood.
5
4
3
2
1
High Degree

More than typical child

Typical

Less than typical

Characteristics
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30.

Is alert beyond his/her years
Likes school
Has interests of older children or of adults in games and reading
Sticks to a project once it is started
Is observant
Has lots of ideas to share
Has many different ways of solving problems
Is aware of problems others often do not see
Uses unique and unusual ways of solving problems
Wants to know how and why
Like to pretend
Other children call him/her to initiate play activities
Asks a lot of questions about a variety of subjects
Is concerned with details
Enjoys and responds to beauty
Is able to plan and organize activities
Has above average coordination, agility, and ability in organized games
Often finds and corrects own mistakes
Others seem to enjoy his/her company
Makes up stories and has ideas that are unique
Has a wide range of interests
Gets other children to do what he/she wants
Likes to play organized games and is good at them
Enjoys other people and seeks them out
Is able and willing to work with others
Sets high standards for self
Chooses difficult problems over simple ones
Is able to laugh at self (if necessary)
Likes to do many things and participates wholeheartedly
Likes to have his/her ideas known
Column Total
Weight
Weighted Column Total
GRAND TOTAL

Does not exhibit

5

4

3

2

1

5

4

3

2

1

The Midland Academy of Advanced and Creative Studies
Parent Nomination Form
Grades K-3
Please complete the following:
What special talents or skills does your child possess?
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Provide examples of behaviors that illustrate these talents
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Reading interests (favorite type of books and/or titles of favorite books)
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Favorite school subjects
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General attitude toward school
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Hobbies and special interests (collections, dancing, building models, swimming…)
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Favorite playtime and leisure time activity
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Additional information regarding your child to better assist The Midland Academy to meet his/her needs
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