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Buckley Education SSAT Flex Test Pre-Registration Form
www.buckleyedgroup.com
ssat@buckleyedgroup.com
toll free: 1.866.948.3803
local: 1.650.401.6140

1204 Burlingame Avenue, Suite 2
Burlingame, California 94010

Email address *
Please complete this form to begin the registration process for the Middle Level or Upper Level SSAT Flex Test.
Student Name *
Your answer
Student Email *
Your answer
Current School *
Your answer
Current Grade Level *
Your answer
Student Date of Birth *
Your answer
Is this for the Middle Level or Upper Level Flex Test? *
Please select one.
Required
Parent Name(s) *
Your answer
Parent Email(s) *
Your answer
Home Phone *
Your answer
Parent Cell Phone *
Your answer
Home Address *
Your answer
How did you hear about us? *
Your answer
Are you currently working with an Educational Consultant? If so, please provide his/her name. *
Your answer
Would you like one of Buckley Education's Educational Consultants to reach out to you regarding your school planning needs? *
Required
Is this for the Flex Test with regular accommodations, or approved accommodations? *
Please select one.
Required
If your student has approved testing accommodations through SSAT, please list them here so that we may schedule the test accordingly. (Please note: Buckley Education will follow the approved accommodations exactly as listed in the SSAT portal following registration.)
Your answer
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