New Student Registration
Please complete the following information about parent/guardian and child in order for us to get started with your child's registration.
Parent First Name
Parent Last Name
Parent Email
Parent Mobile Phone
Home Phone
Address
City
State
Zip
Student information
Student
Student First Name
Student Last Name
Birth Date
School
Grade
Describe your child's academic struggles.
Does your child have an IEP? And/or, has your child had a private evaluation for dyslexia/learning disability? Please describe, and send us a copy of any IEP or evaluation.
Which service(s) are you interested in? Select all that apply
Reading Therapy
Math Therapy
Reading Skills Group
Math Skills Group
Writing Skills Group
Study Skills Group
Academic Assessment
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Add Fields for Additional Student
Submit
