Placement Exam Registration

Parent Name

Parent Phone Number* - -

Parent Email *

Address*

Use Google Smart Search for Address

Address 1:

City:

Country:

State/Province:

Postal Code:

How many students are registering for this exam?*

Student 1 Name*

Student 1 Birthdate *

Current Grade of Student 1*

Student's Current School 1*

Which placement exam is student 1 registering for? *

Student 2 Name*

Student 2 Birthdate *

Current Grade of Student 2*

Student's Current School 2*

Which placement exam is student 2 registering for? *

Student 3 Name *

Student 3 Birthdate *

Current Grade of Student 3*

Student's Current School 3*

Which placement exam is student 3 registering for? -*

Does your student(s) have a Catholic Accommodation Plan, 504 Plan or IEP? If so, please submit the student’s plan to [email protected] at lea*YesNo

Amount$0.00

Payment Method:*

Payment Notes/Additional Info:

Name on Card:*

Email You Want Associated with Credit Card Payment:*

Credit or debit card*

Admissions