KANSAS ASSOCIATION FOR THE BLIND AND VISUALLY IMPAIRED, INC.

ESTHER V. TAYLOR  SCHOLARSHIP APPLICATION SUPPLEMENTAL SHEET

The Kansas Association for the Blind and Visually Impaired (KABVI) will be awarding two $1,000 scholarships to visually impaired students who are enrolled in an academic, vocational, technical or professional training program beyond the high school level.  The KABVI scholarship committee will accept applications from students who are residents of Kansas and are enrolled in a college, university or technical school.  Material must be postmarked on or before April 15 of each year. Send the completed application and all supporting documents to: Phyllis Schmidt, 1916 S.W. 66th St. Topeka, KS 66619.

Esther V. Taylor, for whom this scholarship is named, was a charter member of the Kansas Association for the Blind and Visually Impaired.  She became a music teacher and taught at the Kansas State School for the Blind.  Esther helped craft early special education laws in Kansas long before special education became a mandate of the Federal government.  In her eighties, Esther wrote an autobiography, "The Professor's Family"  about herself and her sister, Eleanor,  exploring the challenges of growing up and becoming educated as blind women during the early 1900's. Esther particularly wanted blind students to be problem-solvers and as resourceful as their sighted peers in coping with the challenges of academics, employment and everyday life.

 ELIGIBILITY CRITERIA

 To be eligible for a scholarship the applicant must:

(1)  Be a visually impaired student admitted to a post-secondary training program for the school year 

2)  Be a resident of Kansas

(3)  Submit a completed, application form together with the required supporting documentation postmarked on or before April 15 of each year.

 REQUIRED DOCUMENTATION

 To be considered for a scholarship the student must submit the following items:

(I)    A completed application form: 

(2)   An autobiographical sketch (please update if you have applied previously) of no more than two double-spaced, typewritten pages. This sketch should include goals, strengths, weaknesses, hobbies, honors, extracurricular activities, achievements, etc. This must be typed; hand-written material will not be accepted.

3)   A certified transcript from the school presently, or most recently attended.

( 4) Two letters of recommendation from current or recent instructors

( 5) Proof of acceptance from a post-secondary school. Entering or transferring students must submit a letter of acceptance from the admissions office.

(6)   Certification of visual status on the form attached to this application.

 Recipients of this scholarship will receive a one year free membership to KABVI.

 


KANSAS ASSOCIATION FOR THE BLIND AND VISUALLY IMPAIRED, Inc.

Esther V. Taylor Scholarship Application Form

 I.     PERSONAL DATA

       A. Name, mailing address, and telephone  number:

          First Name Middle Last          

          Street Address

          City State Zip

          Phone        County

       B. Are you a U.S. Citizen? Yes No

 II.    EDUCATION INFORMATION:

       A. Name and address of the school you are currently attending or have completed (Secondary and post-secondary schools)

             Name   Address

             Name   Address

              1.  Enrollment status:   Full time Part time 

              2.  Number of hours completed to date. 

              3. Major      GPA based on 4.0 scale)

              4. Degree/certificate/diploma sought; BA, BS, MS, etc

              5. Date you expect to receive it.

     B. Name and address of the school you plan to attend during the semester for which you are applying for this scholarship ( if different from A. above ):

          Name 

          Address 

              1.  Enrollment status:  Full time Part time 

              2.  Number of hours you are planning to take per semester

              3.  Major

              4.  Degree/certificate sought: BA, BS, MS, etc.

              5.  Date you expect to receive it:

 III.   FINANCIAL INFORMATION :

        Are you eligible for other financially based student aid? Yes No

 IV. ESSENTIAL SUPPORTING DOCUMENTS:

        A.    Completed application.

        B.    Typed autobiographical sketch: include work experience, extracurricular activities, and/or volunteer service.

        C.    Certified transcript from the school you are attending or most recently attended.

        D.    Two letters of recommendation from current or recent instructors.

        E.    Proof of acceptance from a post-secondary school.

        F.    Certification of visual status on the attached form.

 

                  

 

 

 

 

 

 


Certification of Visual Disability

(This form is to be completed by an ophthalmologist, optometrist, physician, vocational rehabilitation counselor, or independent living center counselor)

 I certify that ____________________________  is known to me and is visually

 Impaired as specified by the following definition:

 "Visual acuity best corrected with conventional spectacles or contact lenses of 20/60 or worse in the better eye, or a visual field restricted to 20 degrees or less in each eye." This also includes those certified as legally blind.

 Date of examination: ______________________

 This is a permanent condition: Yes _____  No _____

 Certifier’s Name: ______________________________

 Degree: ____________________________________

 Title/ Agency: _______________________________

 Address: ___________________________________

 Phone: ____________________________________

 

Signature: _________________________________