New Family Application

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If you are interested in attending PG Retreat for the first time, please complete the following application. The information you provide will be used solely for considering potential new attendees to PG Retreat. Applications are treated with the utmost confidentiality and are normally reviewed by a maximum of two individuals, a founder of the organization and/or an outside professional in the field of gifted education.

Please direct any questions to application@pgretreat.com.

contact information

Contact name *

Street address *

Address continued

City *

State *

Zip *

Country *

Home

( )

Work

( )

Cell

( )

Email *

family members

Because PG Retreat is a family event supporting the social-emotional needs of profoundly gifted children, as well as those of their parents and siblings, please list all family members who may attend.

Parents / Guardians

	First	Last

			Add

Children

	First	Last	Gender	Birthdate
			MF
			MF		Add

For the following sections, please provide information regarding your profoundly gifted child or children, and what you seek to gain from your family attending PG Retreat. Feel free to provide as much or as little information as you feel comfortable offering and even to skip questions entirely. We have felt that various families may fit with PG Retreat for a variety of reasons --based upon qualitative or quantitative factors, or from personal or professional referrals. There is no need to be exhaustive. We can always follow up seeking additional information.

As a gathering of families, as opposed to a professionally operated camp, we generally do not take the approach of "accepting" or "rejecting" applicants. Rather, we seek information to help us advise you as to whether your family would likely benefit from attending PG Retreat, as well as to gain a better understanding of how you would fit into the overall community.

In other words, do not treat this as a test or as a college application, but more as an initial conversation among new friends.

background

Provide a brief description of your child, particularly as related to his or her PG qualities. Include examples of profound giftedness, lists of hobbies and intellectual interests, and anything else that may help us to "get to know" your child.

Describe any challenges your child has faced as a result of being profoundly gifted, including socially, emotionally, academically, etc. Discuss any challenges you have had as a parent raising a profoundly gifted child.

List your child's participation in any gifted organizations, summer enrichment programs, extracurricular activities and other relevant memberships.

expectations

Describe how you heard about PG Retreat and what your expectations are of what it is all about.

Describe what you are hoping your child will get out of PG Retreat.

Describe your child's expectations of and hopes for PG Retreat, if any.

Describe what you personally are hoping to get out of PG Retreat.

assessments

Provide the results of any intelligence tests your child has taken. List test(s), scores, and test administrators. For scores not indicative of PG levels, describe any relevant extenuating factors, such as ceilings, large spreads, and 2E issues.

Provide the results of any standardized aptitude or achievement tests your child has taken. List tests, scores, and ages taken.

Describe your child's current educational environment, along with any significant changes in environment. Identify the setting(s), such as public, private, parochial, homeschool, or community college. Describe any specialized gifted programs in which your child participates and discuss any grade acceleration undertaken.

references

List any references from professionals serving the gifted field, particularly any focused on the profoundly gifted. Note if any specifically advised you to attend PG Retreat. Provide names and contact information. If you wish, you may submit any written refereces by following the instructions at the end of this form.

List any references from other parents who have attended PG Retreat in the past who know your children. Provide names and contact information.

List any references from other professionals, such as teachers, who can attest to your child's gifted qualities. Provide names and contact information. If you wish, you may submit any written references by following the instructions at the end of this form. This input is primarily helpful in the absence of scores or referrals from giftedness professionals or other PG Retreat parents.

Click the submit button to send your application. Feel free to send any supporting documents or materials to application@pgretreat.com. We will respond to you shortly via phone or email.

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