Placement Exam Registration

Student Name*

First Last

Email to be used for testing information (including online testing)*

Contact Phone Number for testing information (including online testing)*

Gender*

Male
Female

Birthdate*

Alternate Phone number:

Testing Date:*

Saturday, December 8, 8AM
Tuesday, December 12, 4PM
Saturday, December 16, 8AM

Parent or Grandparent Legacy

Is the student's parent or grandparent a graduate of PCHS?

Mother

Mother First/Last Name Maiden Name Graduation Year

Father

Father First/Last Name Graduation Year

Grandmother

Grandmother First/Last Name Maiden Name Graduation Year

Grandfather

Grandfather First/Last Name Graduation Year

School Information

From what school will the student graduate this spring?

School Name*

School City*

Student's Religion*

Parish/Church Name

Parish/Church City

Student's Parent/Guardian Information

Father*

Living
Deceased

Mother*

Living
Deceased

With whom does the student reside?*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent Authorization Form Class of 2027 Applicants

I grant permission for Providence Catholic High School to dialogue openly with appropriate parties at my student's current school regarding current levels of performance as it relates to my student's admission and placement for the 2023-2024 school year. In addition, I will allow authorized representatives from Providence Catholic to share entrance exam results with my student's current school for the sole purpose of curriculum planning and placement. I understand that any information exchanged will be kept confidential according to the stipulations of the Family Education Rights and Privacy Act of 1974.

Electronic Signature*

Yes, I agree that Providence Catholic can dialogue and share test scores with my student's school for curriculum planning. and placement purposes

Signature of Parent or Guardian (Please type in full name):*

List the name(s) of the parent(s)/guardian(s) with whom the student resides

Parent/Guardian*

First Last

Maiden Name

Last

Email*

Phone*

Parent/Guardian

First Last

Maiden Name

Last

Email

Phone

Registration Fee:*

Price: $25.00 Quantity:

Total

$0.00

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Email

This field is for validation purposes and should be left unchanged.

Placement Makeup Exam Registration 2023

Parent or Grandparent Legacy

School Information

Student's Parent/Guardian Information

Parent Authorization Form Class of 2027 Applicants

List the name(s) of the parent(s)/guardian(s) with whom the student resides

Calendars

Future Students

Current Students

Parents

Alumni

Faculty & Staff

Placement Makeup Exam Registration 2023

Parent or Grandparent Legacy

School Information

Student's Parent/Guardian Information

Parent Authorization Form Class of 2027 Applicants

List the name(s) of the parent(s)/guardian(s) with whom the student resides

Calendars