PC READS ADVOCATE PROGRAM: Assistance Request
Our Advocate Program strives to provide a personalized experience for families. Assisting families often includes reviewing both school and private assessments, explaining school procedures and services, and reviewing and revising IEP goals and 504 accommodation plans. Our Advocates have completed training through the Dyslexia Training Institute and are Certified Dyslexia Advocates. Please note that our advocates are not attorneys and are not providing legal advice or opinions.
After completing this form, a PC READS Advocate will contact you. Should you not hear from us within 2 weeks, please email Elissa Aten at
. In addition to donations from private individuals, this program is supported by grants from the Park City Community Foundation, the Park City Rotary Club and the Bessie Minor Swift Foundation.
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Parent Phone Number
Parent Email address
Parent Address (Street, City, Zip)
Second Parent Name
Second Parent Phone Number
Second Parent E-Mail Address
Second Parent Address
Student's Current Grade
Student's expected year of HS graduation
Student's Current School
Jeremy Ranch Elementary School
McPolin Elementary School
Parley's Park Elementary School
Trailside Elementary School
Ecker Hill Middle School
Treasure Mountain Middle School
Park City High School
Weilenmann School of Discovery
Park City Day School
Winter Sports School
Please check all below that are applicable:
Family history of reading difficulties exists (parent, aunt, sibling, etc.)
Concerns were presented at a teacher conference
DIBELS assessments are not at benchmark
School has offered to evaluate for a learning or attention disability
School evaluation of a learning or attention disability has been completed
Private testing for a learning or attention disability is complete
Diagnosis of a learning or attention disability has been received
An IEP (Individualized Education Plan) is in place
A 504 Plan of Accommodations is in place
Requesting professional services resource list (tutors, private evaluators, etc.)
We would like to be assigned a PC READS Advocate
We would like our child to participate in the MIND Youth Program
Please provide a brief summary of your child's current situation and the reason for your concerns. If you chose "other" for grade or school above, please include specific information here.
How did you learn about us?
Do you receive the PC READS E-News?
How did you learn about the PC READS Advocate Program?
Previously worked with a PC READS Advocate
PC READS Website
PC READS E-News
PC READS Event
If someone personally referred you to PC READS, please consider sharing their name with us. Thank you!
If you are completing this form on behalf of a student and you are not their parent, please provide your name, email, phone number and mailing address below. Also, please include your relationship to the student (guardian, friend, etc.) Thank you!
I understand that PC READS' Advocates are not attorneys and are not providing legal advice or opinions.
A copy of your responses will be emailed to the address you provided.
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