Registration Form
Dyslexia 101 & Simulation with ALTA @ Nelms Dyslexia Center - March 19th, 5:30 p.m. - 7:00 p.m. - 2781 N College Ave, Fayetteville AR
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
What best describes you or your organization? (check all that apply):
*
Parent
Educator
Student
Other
Optional
How familiar are you with dyslexia?
Not familiar
Somewhat familiar
Very familiar
I work with individuals with dyslexia regularly
I have a personal experience with dyslexia
What questions about dyslexia would you like us to cover?
Do you have any accessibility needs we should be aware of?
Would you like to receive the Nelms Dyslexia Center e-newsletter with updates, resources, and future events?
Yes, please.
No, thank you.
Submit
Should be Empty: