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(please describe)
Tell us about yourself...



ex: 1/2/2005

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


(please describe)

     








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





Tell us about your job readiness skills:


(please describe)


(e.g., Aira)



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



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


(please describe)

Technology





(please describe)



(please describe)
Orientation and Mobility Skills:

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



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.)


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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