Course Registration






Spectrum Resources of North Carolina accepts cash, check, and MasterCard or Visa as payment for services.  Financial assistance has been offered to families via First in Families of NC and Wake County Human Services. For more information regarding financial assistance please contact Spectrum Resources directly.

Registration Form

If you wish to register for our courses, please complete and submit this form. We will review your information and contact you within three business days to verify registration and payment information.

Class sizes are limited, so please register early. If you have any questions regarding registration or availability, please contact us at 919.227.9846. Thank you for your interest in Spectrum Resources of North Carolina.

Participant's Name:
Date of Birth:
Parent/Guardian's Name:
Address Street 1:
Address Street 2:
City:
State:
Zip Code: (5 digits)
Daytime Phone:
Evening Phone:
Email:
Please Check Here if You Would Like Us to Contact You About Individualized Family and/or Caregiver Consultation:  Please Contact Me
Desired Social Learning Course:
(See Class Schedules Page)
Current Educational Placement:
1.)Regular Education: No Supports
2.)Regular Education: Some Supports
3.)Self Contained Setting
4.)Other
Current Diagnosis:
If Diagnosis is 'Other' Please Describe:
When and where was Diagnosis received:
Special Interests:
Please briefly describe your child's interests or hobbies
Payment Options:
Full payment for courses due on or before course registration deadline. See  our "Services" page for course description and registration deadline.
Payment Method:
If paying by check or money order, mail payment to:
Spectrum Resources of NC
9600-138 Falls of Neuse Rd. #186
Raleigh, NC 27615
Name as it Appears on Credit Card:
Billing Address:
If different than address listed above
Credit Card Number:
After payment is received a receipt and confirmation for class registration will be mailed to the address you provided on this registration form
Credit Card Expiration Date:
Month - Year
Please Check Here if You Would Like to be Updated on the Latest Course Schedules and Services Offered  Please Add Me to Mailing List
Please Tell Us How You Heard About Spectrum Resources of NC:
Comments:



Please note that after you submit this form you will be redirected to the 'Home Page'. We will notify you as soon as we receive your registration form. A consultant will be in touch soon to discuss the class further and to complete the intake process.

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