Sarah R. Olbris Tester/Evaluator
5324 Challedon Drive, Virginia Beach, Va. 23462-4110
TEL (757) 456-9659
www.thetestinglady.com
Test Registration Form

Parents or guardian’s name _________________________________________________

Student’s name ___________________ Date of Birth _ Grade

Address ________________________________________ City _____________________

State _______ Zip _____________ Phone _________________ Cell ________________

E-mail address________________________________________ (This will be used to communicate
with you about testing only. I will not forward things and I will not give your address to anyone else.)

Circle test choice:

Iowa Evaluation Woodcock-Johnson WRAT Portfolio

Test date request____________________ a.m. p.m.
(Circle one for Iowa tests only)

Science and Social Studies (extra charge) YES / NO

Total amount enclosed _____________ Check # __________

I understand that the balance due is based on the date paid. The earlier I pay the
balance due, the less I will owe!

Self-addressed stamped #10 size envelope enclosed __________

Parent or Guardian Signature ______________________________________________

For office use only

___________ Test Date ___________ Post Card ___________ Late fee (#1)

___________ Test Time ___________ SASE ___________ Late fee (#2)

___________ Test Type ___________ Deposit ___________ Late fee (#3)

___________ Sci. and Soc. ___________ Balance Paid ___________ Post Mark

Student’s name _________________________ Date of Birth ___________ Grade ____

Test date request____________________ a.m. p.m. (Circle one for Iowa tests only)

Student’s name ___________________ Date of Birth _ Grade

Test date request____________________ a.m. p.m.
(Circle one for Iowa tests only)