Placement Test Registration
A Make-up Placement Test will be scheduled for if and when space in the class of 2016 becomes available.
Please complete this form to receive notification of the next test
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| Considering enrollment for which school year: |
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Student Information
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Enter your son's name as it
appears on his birth certificate. |
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| Student First Name: |
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| Student Middle Name: |
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| Student Last Name: |
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| Student Suffix: |
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| Date of Birth: |
(01/01/1990 - MM/DD/YYYY) |
| Home Phone Number: |
(412-555-5555) |
Student Address Information
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| Street Address (Physical Address of Home): |
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| City: |
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| State: |
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| Zip: |
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Mailing Address - Copy From Physical Address
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| Mailing Address: |
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| City: |
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| State: |
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| Zip: |
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| Neighborhood: |
(Oakland, Greenfield, etc.) |
Other Information
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| Names of other sons currently enrolled: |
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| School district in which you live: |
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| Other School District if not listed above: |
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| Religion: |
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| Parish (if Catholic): |
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| Other Parish if not listed above: |
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| School your son is currently attending: |
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| Other School if not listed above: |
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Parent/Guardian Information
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| The parent fields refer to those parents/guardians who live with the student. If the student has a parent that does not live with him, please enter that person in the "Other Parent" section. |
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| Mother's or Female Guardian's Title: |
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| Mother's or Female Guardian's First Name: |
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| Mother's or Female Guardian's Middle Initial: |
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| Mother's or Female Guardian's Last Name: |
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| Mother's or Female Guardian's Suffix: |
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| Mother's or Female Guardian's Home Phone Number: |
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| Mother's or Female Guardian's Day Phone Number: |
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| Mother's or Female Guardian's Cell Phone Number: |
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| Mother's or Female Guardian's Email Address: |
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| Mother's or Female Guardian's Relationship to Student: |
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| Father's or Male Guardian's Title: |
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| Father's or Male Guardian's First Name: |
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| Father's or Male Guardian's Middle Initial: |
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| Father's or Male Guardian's Last Name: |
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| Father's or Male Guardian's Suffix: |
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| Father's or Male Guardian's Home Phone Number: |
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| Father's or Male Guardian's Day Phone Number: |
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| Father's or Male Guardian's Cell Phone Number: |
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| Father's or Male Guardian's Email Address: |
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| Father's or Male Guardian's Relationship to Student: |
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Other Parent/Guardian Information
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| Other parent refers to a parent or guardian that does not live with the student. |
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| Other Parent's Title: |
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| Other Parent's First Name: |
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| Other Parent's Middle Initial: |
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| Other Parent's Last Name: |
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| Other Parent's Suffix: |
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| Other Parent's Street Address: |
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| Other Parent's City: |
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| Other Parent's State: |
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| Other Parent's Zip: |
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| Other Parent's Home Phone Number: |
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| Other Parent's Day Phone Number: |
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| Other Parent's Cell Phone Number: |
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| Other Parent's Email Address: |
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| Other Parent's Relationship to Student: |
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Ethnicity/Race for Federal/State Reporting
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| Is your son Hispanic or Latino?: |
Yes No Decline |
| What is your son's race?: |
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