Order form for the Advanced Dyslexia Certificate course.

Dyslexia Advanced Certificate Group Order - INVOICE REQUEST FORM

Teacher's or group leader's first name (e.g. Mary)
Last name/Surname (e.g. Smith)
Delivery address for course materials: line 1:
Delivery address line 2:
City/town:
State/county:
Zip/postal code:
Country (e.g. USA, UK, etc.):
E-mail address:
Please enter your e-mail address again to ensure accuracy:
Name (e.g. school) and full address to which you would like the invoice made out and sent:
Upon completion of the course, would you like the certificates sent to you for presentation or to the students individually?
How many students are you ordering course materials for (must be at least three students)?
In which currency will you you be paying? (e.g. US dollars)
Total cost of your order:

TYPE IN all the details and then PRINT out this form. Then type and print out your students' names and addresses here, and send both pages to:

Direct Learning Ltd (Group Registrations)
P.O. Box 1111
Guildford, Surrey
GU1 9EH
England, UK

Dyslexia Teacher
'Training Teachers and Parents Worldwide'

Direct Learning is a business name of Direct Learning Ltd. 955 Massachusetts Avenue #290 Cambridge MA 02139 USA and at 2135A boul des Laurentides, Suite 118 Laval Quebec H7M 4M2 Canada., and at 1 - 28 Riddel Street Bulimba Queensland 4171 Australia. Registered Office: P.O. Box 1111 Guildford Surrey. GU1 9EH, UK. Registered in England No.3717331. Website: www.dyslexia-teacher.com