K-1 Reading Intervention DST 2024-2025
MW or TTh Options
Student Information
Child's Name
*
First Name
Last Name
Date of Birth
*
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Month
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Day
Year
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2024-2025 Grade
*
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Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
Current School/Homeschool
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Please share any educational goals, concerns, or background you feel is helpful:
If applicable: previous interventions, evaluation information, IEP/504
Medication Allergies:
Food Allergies:
Other Allergies:
Physician Name
*
Phone Number
*
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Preferred Hospital Name
*
Family Information
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Name
*
First Name
Last Name
Daytime Number
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Cell Phone
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Email
*
example@example.com
Parent/Guardian Name
First Name
Last Name
Daytime Number
Please enter a valid phone number.
Cell Phone
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Email
example@example.com
Emergency/Authorized Pick-Up
*
Cell Phone
*
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Emergency/Authorized Pick-Up
*
Cell Phone
*
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Select Preferred Reading Intervention schedule:
*
M/W 3:30-4:15 PM
T/Th 3:30-4:15 PM
How did you hear about Dyslexia School of Texas
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Website
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School
Diagnostician
Speech Therapist
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Registration and enrollment is not finalized or confirmed until student is assessed and matched for placement by Dyslexia School of Texas.
*
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Regulation Status: Dyslexia School of Texas is not a child care facility and is identified as a single-skills program exempt from Texas Child Care Licensing.
*
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Monthly Tuition 2/week K-1st Reading Intervention
Tuition charged monthly. 30 days cancellation required. Discount codes applied to first two months of enrollment.
$
250.00
Annual Supply Fee
$
100.00
Payment Methods
Debit or Credit Card
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