Recruitment Form Name of Parent or Guardian * Phone or Email * Child Information First name of child * Birthdate * Sex * Male Female Is the child on any prescription medication? * Yes No Does the child have any history of mental illness or learning disability? * Yes No Race/Ethnicity Caucasian African American Asian Native American Hispanic Mixed/Other Does the child speak more than one language at home? Yes No If so, what language(s)? Preferred method of contact Phone E-mail Best time to contact Mornings Afternoons Evenings How did you find out about our lab? * Select one Facebook ad Google ad Business card Paper flyer Lab personnel Word of mouth Other By submitting this form you are agreeing to the terms outlined within the disclaimer presented here. * = mandatory