Dyslexia Parent Course Registration Form
Register for the Dyslexia Parent Course by providing your details below. All fields are required to ensure a smooth registration process.
Parent Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Child's Full Name
*
Child's Age
*
Preferred Course Session
*
Please Select
Morning (9am - 12pm)
Afternoon (1pm - 4pm)
Evening (6pm - 9pm)
How did you hear about the Dyslexia Parent Course?
*
School/Teacher
Friend/Family
Online Search
Social Media
Other
Does your child have prior experience with dyslexia support programs?
*
Yes
No
What are your main goals for attending this course?
*
Do you have any accessibility needs or special requests?
Additional Questions or Comments
Register
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