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Pay-What-You-Can Application
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Parent/Guardian Name.
Your answer
Email Address.
Your answer
Child's First Name & Age.
Your answer
Briefly describe your child's reading and learning needs
Your answer
Has your child been diagnosed with dyslexia or a learning difference?
Yes
No
Suspected but not formally diagnosed
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Why are you requesting PWYC at this time? (No personal financial infomation)
Your answer
What amount are you realistically able to pay per session? (Minimum of $25/session)
Your answer
Are you able to commit to two sessions per week for two months?
Yes
No
Clear selection
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