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Registration Form

Desired tester:
Desired test:
Test date & time:
Parent/guardian Name:
Parents' email:
Parents' home phone:
Parents' cell phone:   Texting available?
Name of school:
Teacher:

Full mailing address including city and state:
 
Student 1
    Full Name: Male Female    Date of Birth: Grade:
Student 2
    Full Name: Male Female    Date of Birth: Grade:
Student 3
    Full Name: Male Female   Date of Birth: Grade:
 

Fees:

Woodcock-Johnson IV (check Basic plus desired additions):
$90 Basic
+ $10 Phoneme-Grapheme Knowledge
+ $10 Reading Fluency and Rate
+ $20 Reading Comprehension
+ $10 Math Problem Solving
+ $10 Basic Writing Skills
+ $20 Academic Knowledge
+ $50 Broad Oral Language
+ $15 Phonetic Coding

$70 Stanford (bubble-in) in Franklin NC

Discounts: Discount names:
Total: Please note amount.  The total will be confirmed and an invoice will be sent.
 
Submission indicates your consent to use of this information for test administration purposes.  See Privacy for more information.
achievementtesting.info