S.M.T./E.M.S. Training Registration Form

Registration Form/Formulaire d'inscription
The training sessions are offered in both / Les sessions de formation sont offertes en

English/Anglais

(S.M.T.) Simultaneous Multisensory Teaching

and/et

French/Français

(E.M.S.) Enseignement Multisensoriel Simultané
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Email
example@example.com
I would like to be trained in order to be able to tutor:

My child/childrenMy studentsMy clientsOther
To facilitate your training or your group's training, please complete the questions below. Upon submission, we will send you an email with available training dates.
Please select the (INDIVIDUAL) training session you wish to register for.

ENGLISH (S.M.T.) TRAININGFRENCH (E.M.S.) TRAININGIn-PersonVirtualSaturdaysWeekdays
Please select the (GROUP) training session you are interested in.

ENGLISH (S.M.T.) TRAININGFRENCH (E.M.S.) TRAININGGroup of 4-8 individualsGroup of 9-14 indivudalsIn-PersonVirtualSaturdaysWeekdays

S.M.T./E.M.S. Program Materials and Costs(*Required Material for Virtual Sessions)

S.M.T./E.M.S. *Starter Kit ($165.00) Incl. Tactile Alphabet, Missing Letter Deck, Plastic Alphabet Letters, Blocks, Mirror.S.M.T. Levels *1 to 12 ($170.00/ per level) Incl. Teacher Guide, Activity Book and Cards.E.M.S. Levels *1 to 8 ($170.00/ per level) Incl. Teacher Guide, Activity Book and Cards.S.M.T. All Levels ($2040.00/complete program) Incl. Starter Kit, all Teacher Guides, Activity Books, Cards, Tactile Alphabet, Missing Letter Deck, Plastic Alphabet Letters, Blocks, and Mirror.E.M.S. All levels ($1360/complete program) Incl. Starter Kit, all Teacher Guides, Activity Books, Cards, Tactile Alphabet, Missing Letter Deck, Plastic Alphabet Letters, Blocks, and Mirror.
Date

MonthDayYear
Date
Payment Options

E-Transfer (Please send to - cward@dyslexiacentre.ca)Cheque (Please send to HADC, 207 Bayswater avenue, Ottawa, ON. K1Y 2G5)
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Registration Form/Formulaire d'inscription