Achievement Testing Form

1
Verify Identity* This field is required.Please provide your student's Child ID # OR your driver's license # here.
Child ID OR your driver's license #
2
Student's Full Name* This field is required.
First Name
Middle Name
Last Name
3
Have you already paid for this test?
Yes
No
4
Student's Current Grade Level* This field is required.
3
4
5
6
7
8
9
10
11
12
5
* This field is required.
I understand I am registering for a service to be performed on specific dates selected. This is a reservation for services. Family Christian Academy does not provide refunds for these services.
6
Student's Date of Birth* This field is required.
Month
Day
Year
7
Parent/Guardian Email* This field is required.We will send an instruction email on the morning of the test.
8
Requested Test Date
Online: April 7th and 9th ($100)
Online: April 29th and 30th ($100)
On Campus Students: May 6th & 8th ($100)
Other, Pick your own date, private proctor ($150)
9
Requested Test Date (Other)* This field is required.The test will be extended to the following business day if not completed the first day.
Date
Month
Day
Year
10
Checkout* This field is required.Card Processing Fee will be added to the total. No refunds.
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My Bag
1
My Bag
Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
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ORDER SUMMARY
Card Processing FeeUSD
SubtotalUSD
Total costUSD
Achievement Test: Online
$100.00Edit
Back
Achievement Test: Pick Your Own Dates
$150.00Edit
Back
Enter Coupon
Total cost $0.00
Payment Methods
Credit Card
First Name
Last Name
Cash App
After submitting the form, you will be redirected to the Cash App Pay to complete the payment process.
11
Invoice ID
12
Signature* This field is required.
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