Registration Form

Registration Form

First Name

Last Name

Email Address

Phone Number*

County of Residence*

Please note, Project Learn is only available in select counties at this time. If your county is not currently active, we will connect you to resources in your area.

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Child's First Name*

Child's Last Name*

Child's Age*

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Disability

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Name of Child's Current School

Child's Current Grade Level*

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Where is your child in the IEP/504 process?

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Have you had IEP or 504 support in the past?

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Primary Area of Concern

Please let us know what you need help with - it could be a specific IEP/504 issue or just general support. We will also call you to discuss how we can help!

When is your child's annual IEP Review Date?

This information can be found on the front page of the IEP

What is the most recent evaluation date?

This information can be found on the front page of the IEP

Did you child receive free or reduced lunch in 2023-2024?

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Do you need other resources for your child?

Please let us know if we can help you find resources regarding your child's diagnosis or current needs.

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How did you hear about Project Learn?

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