Standardized Testing

Parent FIRST Name*

Parent LAST Name*

Parent Email*

Parent Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Number of students registering*

1
2
3
4

Consent*

I agree to the Testing Policy.

I understand that, after I submit this registration form, I will be emailed an invoice for the registration fee. I will make my payment within 15 days of receipt. I understand that the invoice has a due date for payment, and that if my payment is late I will be assessed a late fee of $20.

I understand that, once I make my payment, the testing fee is NON-REFUNDABLE.

I understand that this test is administered in a group setting and that my child must be able to participate in that setting without creating a distraction for others. During testing hours, I will be available at the phone number specified below and will come get my child immediately if a problem arises. In this case, my child’s test will be taken back and NO refund given.

Student 1 Registration

Student 1: Name (Last, First)*

Student 1: Birthday*

Student 1: Grade Level for Testing*

Student 1: Ethnicity*

African American
Hispanic
Native American
Asian
Pacific Islander
None of these

Student 1: Deerstream Student?*

Yes
No

Student 1: Standard or Full Battery?*

Standard Battery (cost: $75)
Full Battery (cost: $85)

Student 2 Registration

Student 2: Name (Last, First)

Student 2: Birthday

Student 2: Grade Level for Testing

Student 2: Ethnicity

African American
Hispanic
Native American
Asian
Pacific Islander
None of these

Student 2: Deerstream Student?

Yes
No

Student 2: Standard or Full Battery?

Standard Battery (cost: $75)
Full Battery (cost: $85)
None (not registering a 2nd Student)

Student 3 Registration

Student 3: Name (Last, First)

Student 3: Birthday

Student 3: Grade Level for Testing

Student 3: Ethnicity

African American
Hispanic
Native American
Asian
Pacific Islander
None of these

Student 3: Deerstream Student?

Yes
No

Student 3: Standard or Full Battery?

Standard Battery (cost: $75)
Full Battery (cost: $85)
None (not registering a 3rd Student)

Student 4 Registration

Student 4: Name (Last, First)

Student 4: Birthday

Student 4: Grade Level for Testing

Student 4: Ethnicity

African American
Hispanic
Native American
Asian
Pacific Islander
None of these

Student 4: Deerstream Student?

Yes
No

Student 4: Standard or Full Battery?

Standard Battery (cost: $75)
Full Battery (cost: $85)
None (not registering a 4th Student)

Total Amount Due

$0.00

Payment for Test Registration*

Your students' test registration is not complete until your payment is received. Deerstream will email you an invoice for your total registration fee. Payment is due within 15 days. Payment for Test Registration is NON-REFUNDABLE.

I agree to pay the non-refundable invoice within 15 days of receipt.

Today's Date*