Admissions Application

Feel free to reach out to us with any questions or additional materials by email: Admissions@Perkins.org, phone: 617-972-7227 or fax: 617-972-7715

Student



ex: 1/2/2005

Family Contact 1




must be unique for each contact

ex: ###-###-####





Family Contact 2




must be unique for each contact

ex: ###-###-####

School District/Other Contact






ex: ###-###-####
Educational Information




Daily Living Skills

Social Skills

Behavior and Adjustment


Communication


Orientation and Mobility

Medical Information

Other Thoughts

File Upload 

Submit application materials here or by mail, email, or fax. File types that can be uploaded:

  • .doc (Older Microsoft Word format)
  • .docx (Current Microsoft Word format)
  • .pdf (Adobe PDF)
  • .odt (Open Office word processor document)