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Accessible Educational Materials for Children with Print Disabilities

Study Contact Form

To receive further information regarding the Accessible Education Materials study, please fill out the form below. We will be in touch shortly thereafter.

General Information:
School Name
District
Principal
Primary Contact
Phone
Best Time to Contact
Fax
Email
Retype Email
Address 1
Address 2
City
State
Zip Code
District Research Contact Person
District Research Contact Phone

School Contact Information:
Address 1
Address 2
City
State
Zip Code
Phone
Fax
Email

Student Information
Number of Students with an Individual Literacy Plan (ILP):
Fourth Grade
Fifth Grade
Sixth Grade

Number of classrooms:

 
Fourth Grade
Fifth Grade
Sixth Grade
Average number of computers available per classroom:
Fourth Grade
Fifth Grade
Sixth Grade
Type of computers in the school Mac PC Both PC and Mac
Primary IT contact
Phone
Email
Does your school have a NIMAS Contact? Yes No Not Sure
If so how can we contact this person?  
Phone
Email
Fax

Your participation in this study will require installation of specialized reading software. I understand that equipment will be assigned randomly at the classroom level. Therefore one or more of your classrooms may receive equipment. You will be asked to provide student data for each participant in the study whether they receive equipment or not.

I have read and understand the above statement