Skip to main content
Hit enter to search or ESC to close
Close Search
search
Menu
Home
About Us
Donate
search
Please enter the following information and Submit to start the registration process for Take Flight
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
you Professional of
Personal Information
First Name
*
Last Name
*
Address
Address Line 1
Address Line 2
City
— Select state —
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Cell Phone
Work Phone
Email
*
Current Professional Position
School District or Charter School
Job Title
Grade Level
Your Campus
District Administrator
District Administrator Phone
Campus Administrator
Campus Administrator Phone
Your Role
General Educator
Special Educator
Is your administration aware of your application?
Yes
No
Post-Secondary Educational Background: (List most recent first)
Degree
School/Institution
Years Attended
Degree
School/Institution
Years Attended
Degree
School/Institution
Years Attended
Teaching Experience: (List most recent experience first.)
Most Recent
Previous
Previous
Professional Certifications/Affiliations:
List Certs and Organizations
Please briefly answer the following questions:
Why are you interested in applying for this training?
Do you know of any conflicts with the required training dates and seminar dates?
To date, what experience have you had with dyslexia (education, professional or personal)?
How do you intend to utilize the skills as a dyslexia therapist in your district?
Submit
Close Menu
Home
About Us
Donate