Handwriting Group Interest Form
Child's Name
*
First Name
Last Name
Date of birth
*
-
Month
-
Day
Year
Date
Age
*
Gender
*
Female
Male
School Name
Grade Level
Parent/Guardian
*
First Name
Last Name
Phone Contact Number
*
-
Area Code
Phone Number
Email
*
Please indicate which group(s) you are interested in joining below. Our programs director will then be in touch with you via email or phone within 1-2 business days regarding your interest. Thank you for choosing TLC! We are looking forward to working with you
Wednesdays 5-6pm (Metairie)
How did you hear about Therapeutic Learning Center's Groups?
Website
Flyer
Word of mouth
School
Facebook/Instagram
Please give our Programs Director 1-2 business days to contact you about your submission. Thank you!
Therapeutic Learning Center
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