Career Launch Tech Bootcamp 2022 - Page 1 of 5 








(please describe)
Tell us about yourself...



ex: 1/2/2005

Please enter "Prefer not to answer" if you do not wish to disclose pronouns.

     












Career Launch Tech Bootcamp 2022 - Page 2 of 5 

Tell us about your interest in Tech Bootcamp: (be as descriptive as possible)

Please enter a minimum of 150 words.
Tell us about how you access information:


(please describe)


(e.g., Aira)



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



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

Career Launch Tech Bootcamp 2022 - Page 3 of 5 (a few more questions...)

Technology





(please describe)



(please describe)

Career Launch Tech Bootcamp 2022 - Page 4 of 5 (the final stretch….)

Vision and Medical Information:

(diagnosis, functional use, prosthesis, etc.)






(i.e., physical activity)

(contacts, magnifiers, sunglasses, etc.)


(please list any seizure disorders, mental health, behavioral, etc.)

Career Launch Tech Bootcamp 2022 - Page 5 of 5 (the last page)

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 ~


By submitting this form, you agree to our Terms & Conditions and Privacy Policy.
By submitting this form, I grant permission to the Career Launch team to speak with my VR Counselor and/or current School about this application.