Literacy Explorers - Tonsley Group

Registration & Service Agreement

Literacy explorers is a skill building group for children in the early primary school years, aged 5-8. Facilitated by Speech Pathologists and Occupational Therapists the group aims to create reading and writing experiences and engagement in multisensory activities that support pre-reading and pre-writing skills.

Each child will be given 1:1 support that provides individualised therapy within a structured group environment with up to 3 other children.

Aims of the group:

Supporting regulation to sit at the table for a group tabletop task
Social interaction opportunities with similarly aged children.

Your child will get exposure to…

Developing skills to find patterns of syllable, rhyme and initial/final sounds
Use the five short vowel sounds (a, e, i, o, u) to find easy-to-sound-out words.
Play with letters to make words
Child-lead learning and exploration of short texts (books)
Making meaning of texts, reading comprehension skills, and expressing ideas
Forming pre-writing shapes that support the development of letter formation

The group will run for 3 days from Wednesday 17th April to Friday 19th April 2024.Location: Autism SA Southern Hub: 6-8 MAB Circuit, Tonsley

Dates: Wednesday 17th April to Friday 19th April 2024
Time: 9:30am - 11:00am (face to face component)

Please note that the submission of this form does not garantee entry into the group. The first 4 eligible participants to complete this form will secure places in the program and the remainder will be priortised for last minute cancellations. Our team will be in touch with you in the coming weeks with more information to confirm these details.

Participant details

Participant first name *

Participant last name *

Parent/Caregiver first name (if applicable)

Parent/Caregiver last name (if applicable)

Participant birth date *

Email Address *

Phone number: *

Preferred Pronouns

He/Him/HisShe/Her/HersThey/Them/TheirsOther (please specify below)

Other, please specify below

About the participant

What is the participant's diagnosis? *

No diagnosisAutism Spectrum DisorderPhysical DisabilityHearing/Vision impairment (please advise in comment box below)Seizure/Heart Condition (please advise in comment box below)ADHDOther (please advise in comment box below)

Please advise the participant's diagnosis *

How does the participant communicate? *

Please advise what AAC device the participant uses

Does the participant frequently display any of the below behaviours? Please tick which are relevant. *

Other, please specify

Does the participant have any specific interests that they enjoy? *

YesNo

If yes (please describe interests below) *

I confirm that the description of the group above match the participant's NDIS goals and what they would like to get out to the group *

Is there anything specific that you are hoping to achieve from the participant's involvement in this group?

Is there any other information you would like us to know about the participant?

Registration/Service Agreement

Please complete and submit this form to register for the program. Once complete, your answers to the below questions will form your Service Agreement. You will be asked to agree to our Terms and Conditions and the costs of the program. You will receive a copy of your answers once submitted.

Please indicate whether you will be funding the group by NDIS or Fee for Service (FFS) *

NDISFee For Service

I am *

Plan ManagedSelf ManagedAgency Managed

I give approval for a Service Booking to be made for the value of the program *

Plan Manager Name *

Plan Manager email address *

NDIS Number *

NDIS Plan Dates *

Please upload a copy of your NDIS plan

Browse

How much will it cost?

Full program price is $ 1,163.94

Each session includes 1.5 hours face to face and 30 minutes non face to face support.

The cost of the program is in line with NDIS rates.

Please note if using NDIS funding, this will come from your Improved Daily Living Budget.

The relevant policies are:

T&C's Autism SA NDIS

T&C's Autism SA FFS

Photographic/Video Release Authority

I grant Autism SA, its representatives, employees and suppliers the right to take/use photographs/videos of myself and/or my child/children and my property during attendance at the above-identified eventfor use in marketing collateral such as annual reports, publicity materials, advertising, social media and web content.

Response *

Yes, I grant Autism SA the rights aboveNo, I do not grant Autism SA the rights above

I have read and accept the Terms and Conditions of this service, including the cancellation policy *

I have adequate funding available under my Improved Daily Living Budget, and this does not expire during the dates I wish to book *

Captcha *

Please sign *

Draw signature|Type signatureClear