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 ______________________
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 California 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
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