PC READS Advocate Program Application
Applications will be reviewed on a rolling basis through October 2, 2017. This program is supported by a grant from the Park City Community Foundation.
Email address *
Name: *
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Date: *
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Phone Number: *
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Email: *
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Address: *
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City: *
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State: *
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Zip Code: *
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I am a: (check all that apply)
Job Title (if currently employed):
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Please list your educational background (name of institution, degrees earned and area of study): *
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Please select all events below that you have attended: *
Required
List any training, professional development or experience with dyslexia that is not covered in the above question:
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Describe any experience you have working with children or adults with learning disabilities: (250-500 words)
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Why are you interested in becoming a Certified Dyslexia Advocate for PC READS? (250 - 500 words) *
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I agree to the following: *
Required
If selected to become a PC READS Advocate: *
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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