BEYOND the Intro - Registration Form
PREREQUISITE CLASS: ANY INTRO CLASS OR WORKSHOP.
Please complete this form to register for this group coaching. Your name will be added after payment is received (link at the end of the form). This coaching is offered on an individual or group basis. Individually the cost is $70/hour or $35/half-hour. Group coaching is $15/50 min session -- GROUP Coaching ONLY: sign up for a punch card to receive 1 free punch -- 5 punches = 1 free session. Coaching sessions will be run by Mary Beth Steven and/or Lisa Barnett.
Empower Learning Center
Email address you want the Zoom link & all communications about this class sent to (only 1 please):
Your mobile phone number:
I am registering for:
BEYOND the Intro Coaching -- INDIVIDUAL sessions
BEYOND the Intro Coaching -- GROUP sessions
Combination of individual and group coaching sessions
FYI: Classes meet: (Eastern Time Zone -- Detroit MI -- Converter:
Individual coaching -- TBD -- communicate directly to set up a schedule
Group Coaching: Occurs at 9:00 PM every Monday evening Aug 19 - Sept 30
Group: Which sessions are you signing up for?
What type of Prerequisite class(-es) have you taken?
Spellinars (via Real Spelling)
Workshop (via Pete Bowers)
Intro to SWI (via Empower Learning Center/Lisa Barnett)
SWI in the Classroom (via Mary Beth Stevens)
Classes via Rebecca Loveless
Classes via DTI (Dyslexia Training Institute)
Workshop (via Lyn Anderson)
Watched webinar (via IDA-UMB; Sue Hegland; other)
Are you a.....? (check all that apply)
Special Education Teacher
Intervention Teacher (RTI, Title I, etc.)
Parent of struggling student(-s)
University level educator
Administrator/Director of a School
Work with: HIGH SCHOOL age student(-s)
Work with: MIDDLE SCHOOL age student(-s)
Work with: ELEMENTARY age student(-s)
If Other, please list:
What type of student(-s) do you service? (all that apply)
Tier 2 (intervention services/RTI/Title I/etc)
Special Education (Learning Disabilities or other eligibility area)
Researching on behalf of my kids for their school
Other, please list in next box
If other, please list:
Please list your city & state (province &/or country if outside of the US):
If you work in a school or educational business, please list
Your experience level with SWI & reason for taking the class (check all that apply)
Brand new to SWI (you will need an INTRO class before joining in on a group)
Novice --I'm experimenting with SWI but not ready to work with students yet
Novice Plus -- I attempt to use it with students, need to become more comfortable
Got it! -- I understand SWI and use it with students daily
Love it! -- All I do is SWI with students
I don't use it professionally, but want to do this for my own learning
Please list any other reason you are taking this class & any experience level not covered above:
What do you hope to gain from this class?
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