Dyslexia Friendly Librarian Challenge Completion Form

Complete the form below to receive your Dyslexia Friendly Librarian Certificate and a PQBD pin!

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1. Name

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2. Library System

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3. Position at the library

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4. Email Address

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5. Mailing Address

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6. I completed the following activities

DOE Module

IDA Fact Sheets* indicate which ones in the space below

Visit and explore the Decoding Dyslexia Virginia Facebook Page

Dyxlexia documentary

Simulation

I read the following IDA fact sheets:

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7. What impact will this challenge have on your work?

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8. I am interested in hosting a Decoding Dyslexia support group in my library. I understand I only act as host--the participants run the group.

Yes

Maybe, I need more information

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9. My library would like to know how to become a Dyslexia Friendly Library.

Yes-please respond to the comment field below.

Please list who should be contacted with more information on how to become a Dyslexia Friendly Library.

Dyslexia Friendly Librarian Challenge Completion Form

Question Title

* 1. Name

Question Title

* 2. Library System

Question Title

* 3. Position at the library

Question Title

* 4. Email Address﻿

Question Title

* 5. Mailing Address

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* 6. I completed the following activities

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* 7. What impact will this challenge have on your work?

Question Title

* 8. I am interested in hosting a Decoding Dyslexia support group in my library. I understand I only act as host--the participants run the group.

Question Title

* 9. My library would like to know how to become a Dyslexia Friendly Library.

1. Name

2. Library System

3. Position at the library

4. Email Address

5. Mailing Address

6. I completed the following activities

7. What impact will this challenge have on your work?

8. I am interested in hosting a Decoding Dyslexia support group in my library. I understand I only act as host--the participants run the group.

9. My library would like to know how to become a Dyslexia Friendly Library.