WOODCOCK-JOHNSON III SCHEDULING FORM                            PDF version

Brewer Testing Services

2853 Davis Road

East Bend, NC 27018

336-699-3997

pat@brewertesting.com

PARENT(S)__________________________________________________________________________________________________

MAILING ADDRESS___________________________________________________________________________________________

CITY_________________________________________________              STATE______    ZIP CODE__________________________

EMAIL_____________________________________________________________________________________________________

HOME PHONE___________________________________________CELL PHONE__________________________________________

TEACHER NAME(S)___________________________________________________________________________________________

SCHOOL NAME (OPTIONAL)___________________________________________________________________________________

 DO YOU WISH TO ADD THE ACADEMIC KNOWLEDGE TEST FOR AN ADDITIONAL $10?                            YES   NO

TESTING PACKAGE #1 JUST FOR THE STATE $55 (INCLUDES THE 6 AREAS REQUIRED BY NC AND MOST STATES)

TESTING PACKAGE #2 STANDARD TESTING PACKAGE (9 TESTS RECOMMENDED BY THE AUTHORS)

WHICH MONTH DO YOU PREFER?  (PLEASE CIRCLE)

JAN   FEB   MAR   APR   MAY   JUN   JUL   AUG   SEP   OCT   NOV   DEC

WHICH WEEK DO YOU PREFER?  (PLEASE CIRCLE)                    1^ST    2^ND    3^RD    4^TH    5^TH   

WHICH DAYS ARE BEST FOR YOU?  (PLEASE CIRCLE)                MON    TUE    WED    THU    FRI    SAT

WHAT TIMES ARE BEST FOR YOU?                      AM    PM    DOESN’T MATTER

DO YOU HAVE A PREFERENCE OF WHICH FORM YOU WANT USED?   FORM A     FORM B

Please note:  We will do our best to schedule your testing at a convenient time for you. 

ADDITIONAL INFO THAT YOU WOULD LIKE TO SHARE: (especially any special needs or information that would be helpful to me)

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