Summer Camp Application
Email address *
Is your child bright but struggling with oral or written language, spelling or reading?
Attend the Summer Camp at Stellar Academy for Dyslexics
June 17, 2019 – July 12, 2019
(July 4 - 5th Holiday - No Camp)

Timings: 8:15 AM to 12:30 PM
Cost: $1,725

This 4 week program is for 1-8 graders. We use the Slingerland ® Approach to Language Arts
Student Name *
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Date of Birth *
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Age *
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Grade Next Fall *
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Parents Name *
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Address Line 1 *
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Address Line 2
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City *
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State *
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Zip *
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Home Phone *
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Work Phone *
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Cell Phone *
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Allergies?
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Slingerland Screened? *
Name of screener
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Slingerland tutored? *
Name of tutor
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Referred by
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Fall placement? *
Reason for enrolling *
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FREE T-SHIRT INCLUDED : select size *
A $100 non-refundable deposit and application due by June 3, 2019. Balance is due no later than June 17, 2019.
Slingerland training is a pre-requisite to attending summer camp. Please contact Stellar Academy for information on screenings.
38325 Cedar Blvd. Newark, CA 94560 * 510-797-2227 * office@stellaracademy.org * www.stellaracademy.org
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