Register

Your Name (required)

Program

(1) 30 min wkly Reading Class (pre-k only) – $95 mo (2) 30 min wkly Reading Classes – $175 mo (1) 1 hr wkly Reading Class – $175 mo (2) 1 hr wkly Reading Class – $315 mo

Registration

PreK AM Reading Tutorial Kindergarten First Grade Second Grade Third Grade Fourth Grade Dyslexia Program

Registration Fee

 Fall/Spring Supply & Registration Fee $50
 Summer Supply & Registration Fee $50

Parent’s Name (required)

Your Email (required)

Phone

Address

Student’s Name

Date of Birth

Public or Private Elementary School Name

District and Campus Name

Learning Differences

Dyslexia Auditory Processing ADD ADHD Other

School Resources

 CMC
 Brain Gym
 Speech
 Dyslexia Program
 Special Education
 Afterschool Tutoring
 Private Tutoring

Areas in need of development

 Phonetics
 Decoding
 Spelling
 Fluency
 Comprehension
 Written Expression

Persons authorized to pick-up child