Learning Differently 101 for Educators is designed for

Elementary and Middle School educators who serve

5th-8th grade students with Learning Disabilities and/or ADHD.

Thank you for your interest! Please provide your information to be notified of future dates.

First Name

Last Name

School

City

State

Please identify your school type:

What is your current role?

How many years have you been in the education field?

Please describe your role at the school

How did you hear about Learning Differently 101?

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Learning Differently 101 for Educators is designed for

Elementary and Middle School educators who serve

5th-8th grade students with Learning Disabilities and/or ADHD.

First Name

Last Name

School

City

State

Please identify your school type:

What is your current role?

Please describe your role at the school

How many years have you been in the education field?

Please select the session you would like to attend:

Monday, November 2nd at 12-1:30pm PST / 3-4:30pm ESTMonday, November 9th at 3-4:30pm PST / 6-7:30pm ESTMonday, November 16th at 3-4:30pm PST / 6-7:30pm ESTI would like to be notified when additional dates become available

How did you hear about Learning Differently 101?

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What are you hoping to gain from this session?

	Strongly Disagree	Disagree	Slightly Disagree	Slightly Agree	Agree	Strongly Agree
I find that I often do not succeed with my students with mild to moderate learning disabilities even when I try my best
I believe I have the ability to understand my students with learning differences
I understand learning differences and their impact on the learner experience

Please indicate the extent to which you agree or disagree with the following statements:

Mild to moderate learning disabilities include:
Students who have been identified with dyslexia, dysgraphia, dyscalculia, ADD, ADHD, processing disorders or other language based learning disabilities or students who struggle with these same challenges but do not have an identification