Preview mode
Published
Copy responder link
Request edit access
Experience Dyslexia Simulation Request Form

What is Experience Dyslexia®?

This simulation allows participants to experience some of the challenges and frustrations faced by people with language-based learning differences. Participants are guided through three to six learning tasks commonly encountered in the classroom or workplace. These activities are followed by a group discussion tailored to your needs, focussed on experiences shared and lessons learned.

DenCoKID is pleased to offer dyslexia simulations to Denver schools, organizations, community groups, and families. 

  • 90-120 minutes (recommended timeframe)

  • 20 to 60 participants

  • allow 4 weeks to schedule

  • $250 materials fee (FEE WAIVED FOR 2026-27 SCHOOL YEAR)

  • scholarships available

Contact us with questions or to learn more: denverkidgroup@gmail.com 720-222-4704

“If you don’t walk in their shoes, you really don’t understand how to help them.” 

— Maria, Special Educator

Name of Group/Organization Making Request: *
Address of Group/Organization:  *
Name of Contact Person: *
Contact Person Email: *
Contact Person Phone: *
EVENT INFORMATION
Requested Date of Event:  *
MM
/
DD
/
YYYY
Attendee Type: (check all that apply) *
Required
Number of Attendees: *
Event start time:
 *
Time
:
Event end time:
 *
Time
:
Location of event (street address and room #):
 *
Would your group like to apply for a need-based scholarship to help cover some of the costs of the simulation materials?  *
Name and contact information for person at your organization responsible for payment: *

Other comments/questions:


 *
Thank you! After review, we will contact you soon with confirmation of your request. 
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms