Beginning Decoding/Encoding Seminar Registration Form

Please read the following information before continuing to the registration form on this page

1. After completing the application, register by clicking the Submit button at the bottom of the page and the application will be electronically submitted to

2. You will then be taken to a confirmation page to receive a confirmation number, be able to print a copy of the completed form and advance to the payment page.

3. If the seminar is already filled, you will be notified, and your deposit will be returned to you.

4. The required $250 deposit must be paid to MDI in order to be registered for the class. Payment may be made by credit or debit card at In the description field, please indicate which class/location you are paying for, along with the registration confirmation number.

5. To pay by check, please indicate the course name, date, and confirmation number on the memo line. Mail to:

Michigan Dyslexia Institute
532 E. Shiawassee St.
Lansing, MI 48912

6. Full tuition balance must be paid one week before the first day of the class, unless prior arrangements have been made.

7. The deposit is nonrefundable, unless MDI cancels or the class is filled.

8. Upon request, MDI will provide a school district with a description of the Seminar, its staff and a letter certifying successful completion of the seminar for school teachers who have received financial assistance from their school districts.

Registration Form


List degree(s) attained (Bachelor, Master, PhD, other), major(s), institution granting degree and year granted.

Teaching Certificate

If yes, please give details:

Related Education Experience

List names and dates of any other course work, workshops, or other educational experiences which may be relevant.

Work Experience

List last five years only, unless you feel this experience is especially relevant.

Personal Information

List only personal interest, activities, etc. considered relevant to your participation in this Seminar.

Reasons for wishing to take Seminar