College Success Application

College Success@Perkins is perfect for the high school graduate who is blind or visually impaired and wants to be fully prepared for the first year of college, as well as students with prior college experience looking for a highly individualized, skills-based program.

This is an important step toward a successful college career, and this checklist will guide you through the application and funding process.

Only applicants are to complete this form. If you need assistance, please contact  our office by phone at 617-972-7573 or by email at We are here to help!


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ex: 1/2/2005


Email must be different for each individual listed on application

*To add additional contacts use the Add Another Contact link below the first contact
Family Contacts

must be unique for each contact

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

(If different than applicant)

(If different than applicant)

(if different than applicant)

(If different than applicant)

Student Educational Information

ex: 1/2/2005

Short Answers About You 
We want to get to know about you and your interests, plans, and goals. Please complete these questions. (This section must be completed by the applicant.)


Reading and Writing



The next three sections: Daily Living Skills, Social Skills and Organization Skills contain questions with radio button responses. If using a screen reader, please be advised you may need to turn off the virtual cursor before tabbing through the form to mark the appropriate radio button for each question. 
Daily Living Skills (all questions required)
Not Attempted Require Support Independent
Social Skills (all questions required)
Not Developed Developing Strong
Organization Skills (all questions required)
Not Developed Developing Strong
Medical and Mental Health 

(Please consider aspects such as executive functioning skills, self-regulatory skills, anger management, and sleep disorders)

Person Who Is Completing the Application

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

Required Application Documents

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)
If you have any questions about this, please contact the Admission Office:

Please include a letter of reference from two teachers (teachers from this year, or last year are required) commenting on your academic achievements to date, your ability to work in groups, and your ability to contribute to class discussions. Please also include the completed TVI Questionnaire. The TVI Questionnaire can be downloaded here.

Supplemental Application Materials   

Optional Additional Application Materials

Terms and conditions