PSAT Registration for SAISD Home Schooled students

Dare of Test: October 19, 2016

Student name (First M.I. Last) ______Date of Birth ______

Grade level for current school year ______(Only grade 10 or 11 may participate.)

“Home-schooled student” means a student who predominantly receives instruction in a general elementary or secondary education program that is provided by the parent, or a person standing in parental authority, in or through the child’s home. Only home schooled students may participate which restricts this opportunity from being available to students enrolled in online charter schools.

I certify that my family has chosen to educate my child named above using the home school option. I further certify that my student lives within the boundaries of the San Antonio Independent School District in the ______High School service area.

Parent signature ______Date ______

Student must present photo ID at the time of test; this should be a government issued ID such as a driver’s license or state ID, military dependent ID or passport. If the student does not have such the parent may provide the parent’s ID along with a copy of the student’s birth certificate in advance of the test.

Parent/Guardian information:

Father’s name ______

Mother’s name ______

Physical address ______

Mailing address (if different) ______

Email address ______Phone number ______

At least one month prior to the date of the test (September 9, 2016), return this completed form along with proof of residence to the Testing Office at the 1700 Tampico, Building T, San Antonio, Texas 78207. If there are additional questions concerning this registration process, please call 210-554-2465.

It is the policy of San Antonio ISD not to discriminate on the basis of race, color, national origin, age, sex or handicap in its vocational programs, services or activities as required by Title VI of the Civil Rights Act of 1964, as amended; Title IX of the Education Amendments of 1972; and Section 504 of the Rehabilitation Act of 1973, as amended.