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BREWER TESTING SERVICES 2853 Davis Rd., East Bend, NC 27018 (336) 699-3997 or pat@brewertesting.com KAUFMAN TESTING SCHEDULING FORM - Please Check The Desired Test(s) _____KTEA II BRIEF FORM: Includes tests in the basic skills that must be tested annually in NC for homeschoolers (reading, word recognition and comprehension, math computation and application, as well as written language and spelling) COST: $45 (Approximate testing time: 45 minutes) _____KTEA II COMPREHENSIVE TEST: Gives a thorough and detailed assessment of the key academic skills in reading, math, written language, and oral language. This test will give you more detailed and valuable diagnostic information as well as an enhanced error analysis with research based remediation strategies to use with your student. COST: Only $85 at our office. I will test in your home for an additional charge of $10 plus 40¢ per round-trip mile. (Approximate testing time: 2-3 hours) _____KBIT2 BRIEF INTELLIGENT TEST: This test gives a quick measure of verbal and nonverbal cognitive ability, providing parents with an IQ composite score as well as the student’s standard % rank by age. COST: $45. NAME___________________________________________________________________ STREET ADDRESS_______________________________________________________ CITY ________________________________STATE _______________ZIP___________ EMAIL __________________________________________________________________ HOME PHONE______________________ CELL PHONE________________________ Notes: ___________________________________________________________________ Student's Name Grade Date of Birth ___________________________________________ _______ ______-______-_______ ___________________________________________ _______ ______-______-_______ ____________________________________________ _______ ______-______-_______ ____________________________________________ _______ ______-______-_______ ____________________________________________ _______ ______-______-_______ ____________________________________________ _______ ______-______-_______ ___________________________________________ ________ ______-______-_______ |
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Which month do you prefer? |
J | F | M | A | M | J | J | A | S | O | N | D |
| Which days are best for you? | Mon | Tue | Wed | Thu | Fri | Sat |
| Do you prefer morning or afternoon testing? | AM | PM |
Form 42A |