The following list is an example of a referral form used to evaluate intermediate and upper elementary grade students for the elementary challenge program.

Evaluators are asked to evaluate the child by answering seldom, sometimes, frequently, or almost always to the following statements.

• Plans and organizes activities.
• Follows projects through to completion.
• Finds and corrects own mistakes.
• Sets high standards for herself/himself.
• Chooses difficult problems over simple ones.
• Asks questions about a variety of subjects, wants to know "how" and "why."
• Pursues his/her own interests.
• Shows vivid imagination.
• Expresses acceptance of others and their opinions.
• Takes risks in pursuit of learning.
• Likes to share his/her ideas.
• Initiates activities with others.
• Uses varied ways of solving problems.
• Is aware of problems that others may not see.
• Uses unique ways of solving problems.
• Has unique ideas.
• Is able to evaluate alternatives/actions; can make decisions based on reasoning.
• Demonstrates sensitivity toward others and the environment.
• Prefers advanced level reading materials.
• Is motivated to learn.
• Shows interest in global issues.
• Displays a keen sense of humor.
• Has quick mastery and recall of information.
• Self-assertive, critically challenges ideas.
• Concerned about right and wrong, justice.