Placement Test Registration
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Email *
Student Information
First Name of Student *
Last Name of Student *
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Please choose the Placement Test Date that will work best for you. *
Parent and/or Legal Guardian Information
Father and/or Legal Guardian *
Father's Telephone Number *
Fathers' Email Address *
Mother and/or Legal Guardian *
Mother's Telephone Number *
Mother's Email Address *
Does your student have a Medical or Educational diagnosis that may affect his/her testing (for example, additional time, help with reading)? 
*
Required
Does your student an Individualized Education Plan (IEP)? 
*
Required
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