Phone *

(###)

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Has the client received an official dyslexia diagnosis, a specific learning disability (SLD) from school related to reading, a WIST evaluation, or a K-2 screener letter? *

This is required to receive intervention through the INW Dyslexia Alliance.

Yes

No

In the process

Preferred location *

Francis Literacy Center (2904 E. Francis Ave. Spokane WA 99208)

Virtual

Preferred time for intervention *

This is not guaranteed, however helps us get a gauge of what your needs are. Two 30-min sessions are required each week.

Weekdays between 9am-2pm

Afternoons between 3pm-6pm

Other (indicate below)

Donation Amount *

$50 covers the cost to run each session. Any extra funds are directed back into the CAF, assisting other families seeking a similar service but dealing with financial challenges.

$65/session

$60/session

$55/session

$50/session

Other Amount (please state below)

I understand ONE of the following is required to receive intervention through the INW Dyslexia Alliance. Please select which one(s) have been received: *

Official dyslexia diagnosis

Specific Learning Disability (SLD) diagnosis from school related to reading

WIST evaluation from Cedar Literacy Center

K-2 screener letter from your school stating your child has been flagged for literacy difficulties or indicators of dyslexia

I understand the INW Dyslexia Alliance does not accept insurance *

Please confirm by checking box