(EPES Testing Order Form-CA)

EPES TESTING, INC.
Order Form*
Print and then fill out.

Download this form in Adobe Acrobat Format
You can download a sample in Adobe Acrobat format for any test below by double clicking the underlined order number.

Order Number	Test/Grade Sets/Scoring Services	Unit Price	Quantity	Total Price
11104	GRADE 4 READING TEST	30.00
11204	GRADE 4 MATH TEST	30.00
11040	GRADE 4 SET - BOTH TESTS	ONLY $46
11105	GRADE 5 READING TEST	30.00
11205	GRADE 5 MATH TEST	30.00
11050	GRADE 5 SET - BOTH TESTS	ONLY $46
11106	GRADE 6 READING TEST	30.00
11206	GRADE 6 MATH TEST	30.00
11060	GRADE 6 SET - BOTH TESTS	ONLY $46
11107	GRADE 7 READING TEST	30.00
11207	GRADE 7 MATH TEST	30.00
11070	GRADE 7 SET - BOTH TEST	ONLY $46
11108	GRADE 8 READING TEST	30.00
11208	GRADE 8 MATH TEST	30.00
11080	GRADE 8 SET -BOTH TEST	ONLY $46
7005	SCAN SCORING SERVICES: Includes customized forms, scoring, plus FREE CLASS REPORT - (Each student per test) -up to 2500 scan sheets per box	.18
7006	ADDITIONAL REPORT SERVICES (available with 7005 or 7007) INDIVIDUAL STUDENT REPORT (Each student per test)	.15
7009	ITEM ANALYSIS REPORTS (Per teacher, per subject)	1.00
7011	CUSTOMIZED CLASSROOM REPORT (Race, Gender, etc.)	1.00
7012	GRADE REPORTS - (Per subject, per grade)	2.50
7013	TITLE I ANALYSIS REPORTS (#174-185) (EACH STUDENT PER TEST)	.15
7014	PROGRESS REPORT (a graph of the same test comparing up to 4 testing dates for 4 teachers)	10.00
90999	SHIPPING AND HANDLING - 10% each shipment (minimum $15 per box) EXCEPT AK, HI, and outside U.S., add actual shipping charges
90994	2ND DAY AIR - actual charges
90990	OVERNIGHT - actual charges
	Total

*Test items created to measure state instructional standards. Included with every test is a TEACHER SUPPLEMENT including skills measured by each question, the answers to each question, a list of uses of test results, and sample computerized reports if we do your scoring.

Purchase Order #:___________________________

(School systems must submit a purchase order. All others have to be prepaid. Home schools must submit a school address reference with phone number)

Ship to:

Name
Position
School
Street Address
City
State
Zip Code
Telephone (Office)
FAX
Email Address

Bill to (if different):

Name
Position
Address
City
State
Zip

Visa and MasterCard accepted.

Print this Order Form out and mail (or FAX) to:

EPES Testing, Inc.
606 Peach St.
Magnolia, AR 71753
Call TOLL FREE 1-800-488-2689 or Fax TOLL FREE 1-866-306-7901