Level IV Screening REsources

Navy Elementary School

Advanced Academic Resource Teacher

Kristen Scudder

Level IV Referrals Due 01/12/18

Advanced Academic Programs Level IV Referral Form and optional materials for students in Grade 2 who are not in pool and students in Grades 3–7 due to Advanced Academic Resource Teacher (AART) at attending elementary school or school counselor at the middle school.

PLEASE NOTE: Due to the tight time frame, do not wait for test information to submit a referral if you would like your student screened. No exceptions to the referral deadline are made.

Work Samples

Student Work Samples – limit 6 - Up to 4 optional samples provided by parents or guardian, school provides 2 work samples.


A maximum of four additional pages of student work samples on single-sided 8½” x 11” pages. (The school will include two work samples that were produced at school.)

Original stories, artwork, and other student work may be submitted in black and white or color, reduced or enlarged from the original, but must be on standard 8½“ x 11” writing, copying, photographic, or bond paper. Large/oversize pages, small pages, cardboard, tag board, or construction paper may not be submitted. Larger/smaller pages, projects, and photographs may be photocopied onto standard paper. Videos, DVDs, three-dimensional art, spiral paper, notebooks, pocket folders, and two-sided pages may not be submitted. Work will not be returned.

Student Awards or Commendations

Limit 5 (optional) - Provided by parents or guardian

A maximum of five single-sided, 8½” x 11” pages of certificates, awards, honors, accomplishments, letters of commendation, report of previous participation in advanced academic programs, and academic extracurricular activities.

Letters of commendation may be handwritten or typed from adults who know the student, including parents or other relatives, music or art teacher, coach, etc. The appropriate input for FCPS personnel is the GBRSw/C. Therefore, letters from FCPS staff members may not be submitted. Materials will not be returned.

Parent/Guardian Questionnaire

The parent/guardian questionnaire can be submitted with the referral, and allows parents/guardian to provide more information.


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