Have you taken a Structured Literacy Orton-Gillingham training or practicum at the Southport CoLAB in the past?*
Ph.D or Ed D.
If other please explain.
Orton-Gillingham Experience (Check all that apply)*
Orton-Gillingham Classroom Educator
Other (Wilson, PAF, S.P.I.R.E. etc.)
If other, please describe
Name of current employer*
Grade level currently teaching
Dates of employment*
Name of previous employer
Grade level taught in previous school
Dates of employment in previous school
Please explain any additional applicable work experience
Which practicum level would you like to register for?*
What level of OGA coursework have you completed?*
Where did you do your coursework (please include the name of the instructor(s))?*
Can you provide a recommendation or can we contact your previous intructor for a recommendation?*
Are you currently working with students that we can observe?*
Do you have a G-mail address? If so, please provide it. *
Do you currently use Google Calendar?*
Do you have experience using Google Meet?*
Please rate your poficiency with Google Docs on a scale of 1-5, (5 being the highest and 1 being the lowest).*
Do you have experience with Zoom?*
Why are you interested in the Orton-Gillingham approach?*
Please list and additional activites, interests or hobbies that you have. *
How did you hear about Orton-Gillingham training at The Southport CoLAB?*
Would you like to be added to The Southport CoLAB's mailing list to receive information about upcoming professional development opportunities and events?*
No, thank you.
Please provide an email address where we can send a link to your current form.
Email Address :