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HSPT Consent Form

High School Placement Consent Form
  • High School Placement Test (HSPT) & Tutoring

    This test is required for incoming freshman students.


    • HSPT tutoring fee is $75.00 (includes testing materials)
    • Dates for tutoring: January 11 & 18 at 8:30 AM to 12:30 PM
    • Snacks will be provided at break time.


    • HSPT Testing Fee is $75.00.  
    • Date for test: January 25 at 8:30 PM to 12:30 PM
    • The test is only being offered for girls.
    • Girls testing at PC will have their Freshman Application fee waived if the application is submitted by the test date.
    Once you complete the request form below, you will be redirected to make an online payment.



    I assume complete responsibility for any damage, accident or injury that may occur to my/our son/daughter from the time of drop off to pick up from the Pomona Catholic campus. I assume all risks inherent in participating in this program. I understand that participation in this program does not give preferential consideration in the admissions process to Pomona Catholic or any other high school. Parent signature hereby authorizes Pomona Catholic School, and or their staff member, or designee as agent for the undersigned to consent to any x-ray, examination, anesthetic, medical, or surgical diagnosis or treatment and hospital care which is deemed advisable by, and rendered under the general or special supervision of any physician and/or surgeon licensed under the provisions of the Medical provision Act on the medical staff of any accredited hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital.

    It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required, but is given to provide authority and power on the part of our aforesaid agent to give specific consent to and all such diagnosis, treatment or hospital care, which the aforementioned physician, in exercise of his/her best judgement, may deem advisable.  This authorization is given pursuant to the provision of Section 6910 of the civil code of California. This authorization shall remain effective on all dates & times selected.

  • By submitting this form, I give my child consent to participate in the HSPT Program at Pomona Catholic.