Homeschool Standardized Group Testing Registration Form  

Child’s Name _____________________________Grade ______Test Section_____
Child’s Name _____________________________Grade ______Test Section_____

Parent’s Names: ____________________________________________________

              Phone Numbers ______________________________________________

             Address: ____________________________________________

City ___________________________Zip ____________

                Email: ____________________________________________

                Cell or emergency numbers: ______________________________

_______________________________________

                Please list any known medical conditions that may affect
                             your child during testing (e.g. allergies, diabetes, etc.)  

Anything else you’d like me to know about your child?

                 Alternate emergency contact person:  

                     Name _______________________ Phone ____________________

    Please mail this form and the payment  with 2 business-sized (4 X 9½) stamped
self-addressed envelopes to: Christie Miller 2818 Martin Road, Bellingham, WA  98226

Total fee enclosed __________________

 WHA Members = $30 for the first child –  $28 for each additional child
     WHA Non-members = $34 for the first child –   $32 for each additional child
     Add $10 to the fee is you choose to take the Science and Social Studies portions of the test.