Make a Booking Enquiry

The fields were completed based on the last enquiry you have submitted. Please be sure that everything is correct.

Your details

Title

First name

Last name

Email address

Mobile number 1 **

Mobile number 2

Landline number

** Please specify at least one phone number.

Please specify a mobile phone if you’d like to receive SMS notifications.

Street address

City

County

Postcode

For statistical purposes only, please let us know which best describes you:

Beneficiary details

(person receiving the service)

Same details as above

First name

Last name

Date of birth

Age

—

Gender

Male

Female

Non-binary

Prefer not to say

Please provide your main reasons for submitting this Booking Enquiry.
Please note: your Booking Enquiry will not be processed until we have received the relevant completed questionnaires (you will receive a link to these after submitting this Booking Enquiry).
If you have a question that you would like answered before completing the questionnaires, please email us [email protected].

What is your ethnic group? (NB: This information will help ensure our services meet the needs of all ethnic groups).

Service options

Service

If you need any help deciding which service you need, please contact us on [email protected]

Preferred place for the appointment

Assessments and dyslexia support can take place in a range of venues or online, depending on the type of assessment or support required.

Postcode

Please indicate how far you would be willing to travel and whether online support would be of interest to you.

30 miles

50 miles

100 miles

online

Bursary

IMPORTANT NEWS

We regret that bursary applications are currently closed until further notice, due to high volume of enquiries.

Bursary applications will re-open when funding becomes available (most likely early October).

Who is the bursary for?

It's for me

It's for my/our child

Is your child's address and postcode different to yours?

Yes

Please provide the child's address and postcode

What difference will a bursary make to you?

Tell us what difference you think our service that you are applying for (assessment/tuition/consultation) would make to your life, or to your child?
Tell us about the challenges faced and what you hope will change in context of home, education, work, and leisure.
If you would prefer to discuss this, rather than write it down, please feel free to contact us on 01252 792 400.

To ensure our bursaries are used for those with the greatest financial need, please explain your financial circumstances by answering as fully as possible.
If a particular question is not applicable you can write "N/A", but please note that we cannot process your application without all the required financial information.

Please note that we may also request copies of relevant paperwork to support bursary applications.

What is your employment status? (e.g. working; unemployed; student etc) If working, please state role and hours.

What is your partner's employment status (if applicable)? If working, please state role and hours.

What are your (plus any partner's, if applicable), approximate monthly earnings?

If you are a single parent, does your ex-partner contribute to your monthly income? If so, how much?

What are your (plus any partner’s, if applicable) approximate monthly expenses? i.e. rent, essential bills, food, petrol

Do you receive any benefits? If yes, please state a) which ones and b) amounts.

Is your child eligible for Pupil Premium Funding (Free School Meals)? (if applicable)

Why are you struggling financially and why do you think you should be considered for bursary assistance?

I am able to pay the following amount towards the session cost:

Please note that payments can be made in instalments.

All information you provide will be treated in strict confidence and will be used solely for the purpose of assessing your bursary application. A link to details of our Privacy Policy can be found here or a hard copy can be provided on request at [email protected].

**If you wish to withdraw your application or your circumstances change at any point, please contact us at [email protected] to let us know.**

Keep up to date via email with the latest information about Helen Arkell Dyslexia Charity, including news about our courses, events, fundraising initiatives and general charity news.

We promise not to share your details or bombard you with emails! Read our Privacy Policy.

Yes please

Please indicate your preferred method(s) for us to contact you:

How did you hear about us?

Please look out for emails from '[email protected]' and add this address to your contacts in order to ensure that important messages do not go into your 'spam'.

I agree to the Services Terms and Conditions and Privacy Policy