ReaDEFY Membership EnrollmentThank you for your interest in our community! Please give our team up to two weeks to review and respond. Student's Name * First Name Last Name Guardian's Name First Name Last Name Student's Grade Level Student's Birthdate * mm/dd/yyyy Check All That Apply: I have dyslexia My child has dyslexia I'm representing a student with dyslexia My child has not been diagnosed with dyslexia Email * Best contact email Phone * Best phone number to reach you (###) ### #### Mailing Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Thank you for your application! We will review and contact you soon.-The ReaDefy Learning Team
