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Hope nomination scale third

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  • 1. Teacher’s Name/Code: ___________________________________ HOPE1 Nomination ScaleStudent Name/ID #: ______________________________________ Grade: _____ Date: ________________Date of Birth:_________________ Age:___ Sex: Male Female Free/Reduced Lunch American Indian/Alaska Native Asian Black or African American White Native Hawaiian or Other Pacific Islander Mixed Race HispanicWhen rating students on each item below please think about the student compared to otherchildren similar in age, experience, and/or environment.Use the following scale to indicate how frequently you observe the traits and behaviors listed initems 1 – 11. 6 = always 5 = almost always 4 = often 3 = sometimes 2 = rarely 1 = never 6 5 4 3 2 11. Performs or shows potential for performing at remarkably high levels.2. Is sensitive to larger or deeper issues of human concern.3. Is self-aware.4. Shows compassion for others.5. Is a leader within his/her group of peers.6. Is eager to explore new concepts.7. Exhibits intellectual intensity.8. Effectively interacts with adults or older students.9. Uses alternative processes.10. Thinks “outside the box.”11. Has intense interests.12. Please indicate all content areas where the student shows talent. Math Reading Creative Writing Social Studies Science Foreign Language Arts Other ____________________Please provide additional information concerning this child’s potential:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 1 Developed with funding from Jack Kent Cooke 2007 Revised 2/2009