SSAT or ISEE Request Form
www.buckleyedgroup.com
testing@buckleyedgroup.com
toll free: 1.866.948.3803
local: 1.650.401.6140

306 Lorton Avenue
Burlingame, California 94010

**Please note: Buckley Education's main office is located within a historic building in downtown Burlingame. As such, the building has a non ADA compliant flight of stairs.**
Email address *
Complete this REQUEST form to begin the SSAT or ISEE Registration Process with Buckley Education
Student Name *
Your answer
Current School *
Your answer
Current Grade Level *
Your answer
Student Date of Birth *
Your answer
Parent Name(s) *
Your answer
Parent Email(s) *
Your answer
Home Phone *
Your answer
Parent Cell Phone *
Your answer
Home Address (Street, City, State, Zip Code) *
Your answer
Is this for the Middle Level or Upper Level SSAT Flex Test or for the ISEE? *
Please select one. Buckley Education offers the Regular ISEE Paper Test (we do not offer the online test and we do not offer the ISEE with accommodations). For the SSAT Flex Test we offer the regular test or the test with approved accommodations.
Required
Fees for the Tests with Buckley Education (as of August 1, 2019)
For the SSAT: $650 for small group testing. If your child is approved for testing accommodations by the SSAT, specific scheduling and/or rates may apply. The SSAT Flex Test fee is in addition to the SSAT Registration fee.

For the ISEE: ISEE fees are set by the Enrollment Records Bureau (ERB) and posted on their website, www.erblearn.org. .
Scheduling the SSAT or ISEE with Buckley Education *
We will do our best to accommodate your request as close as possible to one of your requested times.
Your answer
Does your student have approved accommodations for the SSAT? *
How did you hear about us? *
Your answer
Please note any special details or circumstances here, if applicable.
Your answer
A copy of your responses will be emailed to the address you provided.
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