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Document 1167728

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Document 1167728
 GIFTED AND TALENTED EDUCATION 12089 Toll Gate Road, Pickerington, Ohio 43147 Phone: 614-­‐834-­‐6400 Fax: 614 834-­‐6410 Written Notice of Appeal Student Name School Grade Date Submitted Parent/Guardian Name Address Phone Email Reason(s) For Appeal: Results of any screening procedure or assessment
The scheduling of assessment Request further review of student data Request consideration for placement in program/services Other: Note: Appeals regarding assessments scores must be submitted ten days from receiving assessments scores. ________________________________________________________________________ Please provide additional comments on the nature of and reasons for this appeal: _______________________________________________________________________ ________________________________________________________________________ Please send to: Gifted Education Coordinator 12089 Toll Gate Road Pickerington, OH 43147 
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