Curriculum Consultation Request Form

AVKO's Free Curriculum Consultation Request Form

AVKO Educational Research Foundation
3084 Willard Road
Birch Run, MI 48415-9404

Call Toll Free: 1.866.285.6612

From outside the U.S.: 810.686.9283
Fax: 810.686.1101
E-mail: Gloria@avko.org

Name:

Phone Number:

E-mail Address:

Curriculum Needed in These Subjects:
Reading
Spelling
Handwriting
Keyboarding
Math
Composition

Student Information:

Confirmed or Suspected Disabilities/Deficits/Pathologies/Diagnoses:
Attention Deficit-Hyperactivity Disorder (ADHD)
Dyslexia (Reading Disorder)
Dyscalculia (Math Disorder)
Dysgraphia (Writing Disorder)
Low IQ
Mental Retardation (MR)
Autism
Asperger's Disorder
Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS)
Giftedness:

I Need a Program That...
is inexpensive
is very quick (per session)
works very quickly (across multiple sessions)
requires little to no preparation work
requires little to no parent/teacher involvement
Other (Please specify):

Additional Info:

www.avko.org