The Gift of Dyslexia Online Registration Form

Registration Form - Gift of Dyslexia Workshop

Online via Zoom, timing will depend on time zones of participants

no later than 12 noon-7pm NZ daylight time

Register early, as the number of places is limited to 20.

Minimum numbers apply so do not make irrevocable arrangements without confirmation.

Early-bird rate NZ$1495 incl GST. Registration & payment required 30 days before start.

Regular rate NZ$1725 incl GST. Registration within 30 days closes 14 days before start.

Please note that your place will not be confirmed until payment is received.

Dates of Workshop

e.g. 30 September - 4 October 2024

Name

First NameLast Name

Phone

Email

example@example.com

Delivery Address for kit (no PO Boxes please)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Payment Method

NZ Resident - Direct Credit: An invoice will be issued with account detailsOverseas - Credit Card: An invoice will be issued via PayPal

Billing Address (if different from above):

Name

Address

Email

example@example.com

Phone Number

Area CodePhone Number

Any questions please contact Margot Young on +64 4 478 2208 or +64 21 673119

Davis Dyslexia Association Pacific, 23-29 Broderick Road, Johnsonville, Wellington 6037, New Zealand

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