Application - Summer Literacy Groups
Thank you for your interest in our summer literacy groups.  Please complete the application form below.  If your child is deemed a potential candidate, we will contact you to schedule a free 30 minute screening session on Zoom in order to assess your child's current literacy skills. 

Please visit our website for further information and frequently asked questions More Information or feel free to email us at info@westcoastliteracy.ca.
Sign in to Google to save your progress. Learn more
Email *
Child's Name *
Child's Date of Birth *
MM
/
DD
/
YYYY
Address *
Parent Contact Information
Parent Name(s) *
Parent Phone Number(s) *
Parent Email(s) *
What school does your child attend? *
Please select your child's current grade (i.e., their grade for the 2023/2024 academic year) *
What are your main concerns about your child's current reading and spelling ability? *
Has your child ever had their reading skills assessed?   *
Required
If you answered YES to the above, please provide any relevant information (e.g., letter-sound knowledge; ability to read CVC/CCVC/CVCC words; assessment scores or reading level)
Does your child have a history of or current challenges with the following: *
Required
If you answered YES to any of the above, please provide additional information if available:
Has your child ever had a speech-language assessment or attended speech-language therapy? *
If you answered YES to the above, please provide additional information if available:
Finally, what do you hope your child will gain from attending our summer literacy groups? *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of West Coast Literacy. Report Abuse
Google Forms