Placement Test Registration Form

Student Last Name This field is required This field needs to be a valid value

Student First Name (legal) This field is required This field needs to be a valid value

Parent/Guardian 1 Name This field is required This field needs to be a valid value

Parent/Guardian 1 Cell Number This field is required This field needs to be a valid value

Parent/Guardian 1 Email This field is required Parent/Guardian 1 Email needs to be a valid email address.

City This field is required This field needs to be a valid value

State This field is required This field needs to be a valid value

Zip Code This field is required This field needs to be a valid value

Where does the student currently attend school? This field is required This field needs to be a valid value