Apply for a Scholarship! Parent Name * First Name Last Name Email * Phone (###) ### #### Child's Name First Name Last Name Child's DOB * mm/dd/yyyy First Name Last Name Child's Grade * First Name Last Name Child's School * First Name Last Name Has your child been diagnosed with dyslexia? * Yes No Is your child in Structured Literacy? * Yes No Unsure Any other information you'd like us to know? Thank you!
