Reading Clinic Registration Form

Name of Student:		Date:
Name of Class:		Date(s) of Class(es):
Time:		Grade of Student:
A minimum $25 (USD) deposit is required for registration to be complete. Please contact us for method of payment (801) 466-4214. All fees are to be paid in advance of the first class.
Has a student or family member in your same household attended our classes before?			Yes No
Name of Parents:		E-Mail Address:
Address:		City:
State or Country:		Zip:
Home Phone:		Office Phone:
Register through the Reid Foundation.  All classes are held at the Reid School,  2965 East 3435 South, Salt Lake City, Utah.  Call 486-5083 or 466-4214 for further information.  There are no refunds for missed classes.