School / Organisation Booking Form
Level 4 Certificate: Professional Dyslexia Awareness, Comprehensive Screening and Targeted Intervention This form is for schools who are funding the course place for a member of staff. For all other enquiries please email: courseenquiries@dyslexia-academy.co.uk
School Name
*
School Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of person completing this form
*
First Name
Last Name
Email
example@example.com
Position within School
Please confirm by typing 'YES' that you are authorised to make this booking and that the school/organisation is funding the full cost of the Level 4 Certificate Course place of £1785. Non payment within 30 days will result in the course place being cancelled.
Please provide School Email Address for Invoice to be sent to
Please provide a Purchase Order Number
Name of Course Attendee who will be completing this course
What is the Course Attendees Job Role within school?
Email of Course Attendee
Submit
Should be Empty: