The Wake
• Kendall Group PLLC
Psychological & Educational Services
ADMISSIONS TESTING INFORMATION FORM
Child's name ________________________________________________________________
Date of birth _____________________________________ Age _______________________
Parents' full names and address(es):
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Telephone numbers ____________________________ ____________________________
E-mail address _____________________________
What is the best way to reach you? ___________________________
Has child had previous admissions test? ____________ yes _____________ no
If yes, date of test (month and year) __________________________________
Signature
_________________________________________________________
Date __________________________________