JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Placement Test Registration
There is a $10 fee for the test.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Student Information
First Name of Student
*
Your answer
Last Name of Student
*
Your answer
Gender
*
Male
Female
Date of Birth
*
MM
/
DD
/
YYYY
Please choose the Placement Test Date that will work best for you.
*
March 2nd - 8:30 - 11:15 a.m.
April 20th - 8:30 - 11:15 a.m.
June 1st - 8:30 - 11:15 a.m.
Other:
Parent and/or Legal Guardian Information
Father and/or Legal Guardian
*
Your answer
Father's Telephone Number
*
Your answer
Fathers' Email Address
*
Your answer
Mother and/or Legal Guardian
*
Your answer
Mother's Telephone Number
*
Your answer
Mother's Email Address
*
Your answer
Does your student have a Medical or Educational diagnosis that may affect his/her testing (for example, additional time, help with reading)?
*
Yes
No
Required
Does your student an Individualized Education Plan (IEP)?
*
Yes
No
Required
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Lutheran High School of Kansas City.
Report Abuse
Forms
