Career Launch Application

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(please describe)
Tell us about yourself...



ex: 1/2/2005


(please describe)

     








Tell us about your career goals: (be as descriptive as possible)

Please enter a minimum of 150 words.

Please enter a minimum of 150 words.

Please enter a minimum of 150 words.


Let us know what you’ve done in the past:

(If so, please provide a brief description, including responsibilities and approximate hours worked per week)

(If so what and for how long?)

(If so, please list them)

(If so, please attach)

Tell us about your job readiness skills:

(check all that apply)

(please describe)

(e.g., braille digital recorder, braille notetaker, laptop, tablet, other)

(e.g., Aira)


(e.g., watch, phone, rely on others, etc.)

(e.g., laptop, iPad, braille notetaker)

(check all that apply)

(please describe)

Which tasks are you proficient in?

(check all that apply)

(check all that apply)

(check all that apply)

(check all that apply)

(please describe)

(check all that apply)

(check all that apply)

(please describe)
Orientation and Mobility Skills:



(e.g., long cane, low vision devices, sighted guide, walker, etc.)




(e.g., public transportation, Uber, family member)

(check all that apply)


Vision and Medical Information:

(diagnosis, functional use, prosthesis, etc.)






(i.e., physical activity)

(contacts, magnifiers, sunglasses, etc.)



(please list)


(please list any seizure disorders, mental health, behavioral, etc.)
Please list at least one reference

References should be one of the following: a teacher of the visually impaired (TVI) you worked with in high school, a college professor, or a past or current employer.





Required Documentation
The following documents are a required to complete the application process. If the documents are not submitted with this application, a member of the Admissions Staff will be reaching out to you to obtain the documentation.

Thank you for taking the time to complete this application. We look forward to reading it. We review applications as they come in and will confirm receipt of  your application within one to two business days!

~ The Admissions Staff at Perkins School for the Blind ~


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