KABVI NEWS
Published Quarterly By
An Affiliate of the American Council of the
Blind
Mission
KABVI strives to increase the
independence, opportunity, and quality of life for all blind and visually
impaired Kansans, and to assist us in taking our rightful place as equals among
our sighted peers.
Volume
55 Spring
2012 No. 1
KANSAS ASSOCIATION for the BLIND and VISUALLY
IMPAIRED
Corporate Office, 603 SW Topeka Blvd., Suite
304 B
Topeka, Kansas 66603
Telephone: 785-235-8990 or,
In Kansas only, 1-800-799-1499
E-mail:
kabvi@att.net
Web sites:
www.kabvi.com and
www.kabviyouthconnection.com
Editor,
Associate Editor,
Nancy
Johnson Ann
Byington
714 SW Wayne
Ave. 909 SW College
Ave.
Topeka, KS
66606 Topeka, KS
66606
(785)
234-8449
(785) 233-3839
Supermom1941@sbcglobal.net
abyington@cox.net
Chairman of the Board and President
Ann Byington
909 SW College Avenue
Topeka, KS 66606
(785) 233-3839
abyington@cox.net
SEND ADDRESS CHANGES TO:
Membership Secretary, KABVI
The purpose of
KABVI NEWS, published by the Kansas Association for the Blind and Visually
Impaired, Inc. (KABVI), is to promote the general welfare of the blind and
visually impaired in Kansas. KABVI NEWS shall reflect the philosophy and
policies of the Association, report the activities of its members, and include
pertinent articles pertaining to blindness and low vision.
Publication Policy: Send us your news, views, articles, and features.
Materials in braille, on tape, on computer disk (Microsoft Word, plain text, or
ASCII), or typewritten (double-spaced) will be considered. When quoting from
other published materials, please include dates and sources. Unsigned material
will not be considered for publication. If you send a stamped, self-addressed
envelope, original materials will be returned. Articles for publication must
reach the editor by January 22, April 22, July 22, and October 22 of each
year. Editorial staff reserves the right to edit submitted materials.
Membership renewal letters are sent annually to persons who have not
paid dues. If responses are not received within a reasonable time, names of
those persons will be removed from KABVI’s mailing list and their subscription
to KABVI NEWS discontinued. Membership is open to anyone who is interested, but
is not required for receipt of KABVI NEWS. A membership renewal form on which
you can indicate your newsletter preferences can be found at the end of each
issue. Thank you for your cooperation.
***
Table of Contents
Kansas Advisory Committee for the Blind and
Visually Impaired Meeting Report,
by Ann Byington
Notions,
by Nancy Johnson, Recording Secretary
How to Participate in the State Wide Conference
Calls, 7:00 PM CST,
Third Thursday Each Month
Report from the Board of Directors,
by Nancy Johnson, Recording Secretary
How Does Work Affect My Check Benefits
Tantalizing Tidbits,
compiled by Nancy Johnson
In Memoriam,
compiled by Nancy Johnson
Directors, 2012
2012 KABVI Membership Application
Esther V. Taylor Scholarship
Supplemental Sheet
Esther V. Taylor Scholarship
Application Form
***
Kansas Advisory Committee for the Blind and
Visually Impaired Meeting Report
By Ann Byington
The KS Advisory Committee for the Blind and
Visually Impaired (KACBVI) met on January 5th. Following
introductions/welcome by Madeleine Burkindine, Committee co-Chair, Mike
Donnelly, KS Rehabilitation Services (KRS) Director, reported statistics on the
Older Blind Program. KABVI members will recall that this is what used to be the
Kan-SAIL program and now is handled through contractual arrangements with
Envision, Wichita; Alphapointe, KS City, Mo.; and Prairie Independent Living
Resource Center Partnerships. The report stated:
“Older Blind Independent Living (OIB) Services
449 consumers received OIB
services in FY 2011.
Alphapointe served 102 consumers; Envision
served 228 consumers; and the Prairie Independent Living Resource Center (PILR)
partnership served 119 consumers.
In addition, a total of 887consumers, family
members, staff and community providers attended 38 outreach activities conducted
throughout the state to learn more about services to support independent living
for older blind Kansans.
Of the 449
consumers receiving direct services, the majority were female, white and
residents of private homes. The age group of persons 80 to 89 years old had the
most consumers with a total of 171.
The average cost per person receiving OIB
direct services in FY 2011 was $1,018.
The most frequently used OIB services were
provision of assistive technology (AT) devices with 61% of consumers using this
service. Fifty-two percent of consumers received daily living services. (We
later learned that this category included orientation and mobility
services/training.) Thirty-nine percent of consumers received AT (assistive
technology) services and training.
The top referral sources statewide were eye
care providers with 36% of the referrals, other with 20% of the referrals,
senior programs with 10% of the referrals, and family/friends 9% of the
referrals.
Alphapointe served consumers in 6 counties.
Envision served consumers in 10 counties. PILR Partnership served consumers in
31 counties.
Of the persons receiving OIB services through
community-based contractors, 96% received a functional gain as a result of
services or are still receiving services to reach a functional gain.
Capacity Building: The PILR Partnership
created a curriculum to increase the capacity of Centers for Independent Living
to more effectively serve persons who are blind or visually impaired. This was
presented at the 2011 Disability Caucus. The manual for this training can be
found at
http://www.ikanliveindependently.com.
The PILR Partnership has dedicated four staff
to becoming certified Orientation and Mobility Specialists. One person will
obtain certification in March, one in August, and two in December.
The PILR Partnership has also dedicated four
staff to becoming certified in Braille instruction. One person will obtain
certification in September, two by December, and one by June 2013.”
Madeleine Burkindine and Chris Owens were
re-elected to serve as co-chairs for one more year. The Annual Report Committee
was thanked for its work toward submitting this document to the Governor.
The remaining discussion focused on the
continuing reorganization of Social and Rehabilitation Services (SRS), including
the recent resignation of Secretary Rob Siedlecki.
House Bill 2442 was also discussed as the
Governor’s Office’s attempt to increase employment of persons with disabilities
within the coming year. The goal is to employ one thousand persons during the
year in certified businesses, with 20% of the business workforce being disabled.
Contract bidders would receive a 10% credit if they either employed persons with
disabilities or purchased products from such certified businesses.
The next meeting of KACBVI is scheduled for
early May.
***
Notions
By Nancy Johnson
Some distractions simply must be shared! They
explain why concentration is sometimes difficult. My five-pound Yorkshire
terrier, Sidney, has learned to climb into my lap. He hops onto the footstool I
keep under my desk and climbs up my leg to my lap. He will do it several times
in succession, so putting him down doesn’t stop the distraction. This time I
set him on the desk, and he played hide and seek with me, moving behind the
monitor from one side to the other. And here he comes up my leg again!
I completed my Master’s degree in education
with emphasis on adult education and training January 16. I hope KABVI will
expand into the area of public education. I believe people can do much to
prevent or lessen vision impairment and thus the need for treatment beyond
routine examinations. But we have a considerable amount of work to be done
before we can expand into that arena.
This organization MUST work on fund raising if
it wishes to continue what it now does; it must document exactly what it does.
KABVI is a small nonprofit organization of volunteers. One way to document our
work is by tracking the number of hours we spend and identifying the projects we
do for the benefit of KABVI. I know, for example, that the technology committee
tracks their time. I’m tracking the time I spend in the office. I have trouble
documenting the time I spend on KABVI News because of distractions, but I’ve
estimated 20-30 hours per quarter. The youth activities committee meets an hour
to an hour and a half each month, which can add up to as much as nine hours of
volunteer time each month because six members are on the committee.
Another advantage of tracking volunteer time is
that we will be able to see more clearly what’s going on across the state.
Knowing where your interests lie could possibly help us develop some fund
raising projects.
We need information like this when we write
grant proposals. If you have a committee meeting, if you develop a project –
whatever you do for KABVI – tell me about it and please let me know how much
time you put into it. I think we’ll be amazed by the work people do, and
pulling it all together will give us information we can use when we need data.
Let’s try. If you have e-mail, send your hours to KABVI with a subject of
“volunteer hours” and I’ll see if I can pull them all together. Include a
statement of what you were working on. Use the toll free phone number and call
me with your hours. I’m spending several hours a week in the office, and we
have one additional person who may be able to help there.
Also, we have a large print brochure that
outlines who we are, what we have done, and what we are doing. We will be glad
to provide copies so you can share. Let’s pull together and move this
organization forward.
***
How to Participate in the State Wide Conference
Calls
7:00 PM CST, Third Thursday Each Month
Note:
You are responsible for
your normal long distance fees from your existing long distance provider.
Your Conference Telephone Number:
(712) 432-6100
Participant Pass code: 126083# (pound
sign key on your telephone)
How to Join the
Conference:
1.
Dial 1-(712) 432-6100 and
2.
Enter the Pass Code 126083 followed by # (pound sign key).
If the conference is not in session, the system
will put you on hold until the moderator arrives.
During the Conference -
Conference Commands:
Press *3 – Exit Conference
Press *4 – Help Menu
Press *6 – Mute Individual Line
***
Report from the Board of Directors
By Nancy Johnson, Recording Secretary
President Ann Byington convened the meeting of
the board of directors January 21, 2012, at the corporate office. Eleven
directors were present.
Approval of credit card transactions was
discussed. The bank is now charging $20 per month for their services whether or
not a credit card is used. They offered a program for seasonal use of credit
cards. It was decided to use this option. KABVI can no longer renew
memberships with credit cards while service is down. Credit cards will be
accepted during golf tournament and convention times. PayPal is being
investigated.
Grant funding for the office manager is
expired. The board agreed to keep Colleen Talley working through March, which
will take the organization through its heaviest work season, and beyond if
funding is procured. Using volunteers to assist with some office work was
discussed.
The Kansas Advisory Committee for the Blind and
Visually Impaired (KACBVI) met January 19, 2012. The committee is looking for a
parent of a visually impaired child. Interested parents should notify the
office of Michael Donnelly.
Ann Byington
appointed a Grants Committee consisting of Colleen Talley, Nancy Johnson, and
Michael Byington to work with fund raising.
Convention
sites were reviewed with three potential sites available.
1.
Hold the convention at the Kansas State School for the Blind (KSSB) in
conjunction with the Kansas Association for Education and Rehabilitation of the
Visually Impaired (KAER).
2.
Holiday Inn, Lawrence
3.
McPherson Best Western.
After comparing the offerings of each and a six
to five vote of board members present, Kansas City was chosen as the 2012
convention site. KABVI’s convention will immediately follow the KAER meeting.
Accommodations will be available at the School for the Blind and, for those who
prefer not to stay in the dormitory, near-by hotel accommodations are
available. This arrangement will go a long way toward reducing the cost of the
convention for KABVI and its members. Dates will be coordinated with the KAER
conference and announced in the summer issue of KABVI News.
Two $1,000 scholarships are offered again this
year. The application is available on the kabvi.com website, at the end of this
newsletter, or by contacting the KABVI office. Application deadline is April
15, 2012. When packets are sent, envelopes will state scholarship information
is enclosed.
Annual membership letters have been sent. If
you did not receive one, please contact the KABVI office to let us know so we
can make certain our address information for you is correct.
Monthly conference calls are planned at 7:00 PM
CST the third Monday of each month. Presenters are scheduled for the first part
of the calls. February 20, Dana Carter, of Talking Books is scheduled.
Michael Byington plans to attend the American
Council of the Blind annual President’s and Legislative meetings.
KABVI’s current legislative concern involves the
rights of parents with disabilities and their children. A parent’s disability
alone must not be grounds for removing a child from the home.
Nancy Johnson apologized for the lateness of
sending KABVI News. She thanked Ann Byington and Colleen Talley for their
help.
KABVI’s website is receiving 115 hits per day,
so it is being used. The board encourages the use of Face Book as well. Paul
Berscheidt has added a good deal of information on Face Book.
The next meeting of the Board of Directors is
scheduled for April 21, 10:30 AM, at the corporate office. Meetings are also
scheduled for July 21 and the post-convention board meeting.
***
How Does Work Affect My Check Benefits?
Retrieved from
http://www.ssa.gov/work/receivingbenefits.html#check 2/1/2012
First, you should know that if you go back to
work, you will NOT automatically lose your disability benefits. The Ticket to
Work and special rules called "work incentives" allow you to keep your cash
benefits and Medicare or Medicaid while you test your ability to work. For the
Social Security Disability Insurance (SSDI) program, there is a trial work
period during which you can receive full benefits regardless of how much you
earn, as long as you report your work activity and continue to have a disabling
impairment.
The trial work period continues until you
accumulate nine months (not necessarily consecutive) in which you perform what
we call “services” within a rolling 60-month period. We consider your work to be
“services” if you earn more than $720 a month in 2012. This amount is unchanged
from 2011. After the trial work period ends, your benefits will stop for the
months your earnings are at a level we consider "substantial" -- currently
$1,010 in 2012. This amount is changed from 2011. For 2011, this amount was
$1,000. Different amounts apply to people who are disabled because of blindness.
The monthly SGA amount for statutorily blind individuals for 2012 is $1,690. For
2011, this amount was $1,640.
For an additional 36 months after completing
the trial work period, we can start your benefits again if your earnings fall
below the "substantial" level and you continue to have a disabling impairment.
For more information about work incentives, we recommend that you read the
pamphlet,
Working While Disabled-How We Can Help (SSA Publication Number 05-10095).
If you receive Supplemental Security Income
(SSI) your work may affect the amount of your check. However, we do not count
the first $65.00 of earnings in a month plus one-half of the remainder. This
means we count less than one-half of your earnings when we figure your SSI
payment amount. You may still qualify for other work incentives, such as Ticket
to Work, and continue to receive Medicaid.
While participating in the Ticket to Work
Program, you may be able to use a combination of other work incentives to
maximize your income until you begin to earn enough to support yourself. Some of
these work incentives include:
A Trial Work Period (TWP)
Expedited Reinstatement of Benefits (EXR)
Deferral of continuing disability reviews (CDR)
A plan for achieving self support (PASS)
To find out specifically how your participation
in the Ticket to Work Program could affect your disability benefits, you may
contact a Work Incentives Planning and Assistance (WIPA) project in your state.
You can find a list of the WIPA projects by state using the
Service Provider Directory.
***
Tantalizing Tidbits
New Voices in Talking Books:
We are happy to have Hillary McHenry as a new member of the Kansas Talking Books
network. Hillary joins the Emporia staff as library assistant/production
manager. She will be working with our recording program to produce Kansas
titles in the NLS digital format and spearhead the development of access to
locally produced magazines onto digital cartridges. Hillary is a graduate of ESU's
library school. She has been an Emporia resident since 2008 and comes to us
with experience as a teacher and school librarian. We look forward to the
possibilities for expanded services and resources as we move through the New
Year.
We also recently
received approval to fill the Readers' Advisory position vacated by Mike Hall in
late November. We are happy to announce that Kathryn (Katy) Patrick will join
the Emporia staff as a Readers Advisor on January 26. Katy is also an ESU
library school graduate. She is an avid reader of many types of books,
but fills a particular niche in that she, like Mike, has a passion for science
fiction/fantasy. As a college student and graduate assistant, Katy worked in
libraries providing reference and technical support services. Katy also served
as a board member with the Emporia Public Library's Friends group while
attending ESU.
We feel fortunate to have these
two individuals join the existing talents throughout the Kansas Talking Books
network.
E-learning Opportunities:
The American Foundation for the Blind
offers digital learning through online publications, webinars, and online
courses available through its
fully accessible eLearning Center.
You can find courses on aging, vision loss, and employment. There are a number
of great courses to choose from, with more on the way. Please check them out
and let us know what you would like to learn about in the future. Additionally,
the eLearning Center and
AFB CareerConnect
offer the
Job Seeker's Toolkit,
a free self-paced, online course on the employment process. The course is aimed
at helping teens and young adults prepare for employment. You can navigate this
digital offering and become more self-aware, build tools such as your resume and
cover letter, and prepare for that interview!
Application for reading DAISY books on smart
phones: The Darwin Reader for
Android, created by New Designs Unlimited, recently released a new product for
reading DAISY books on smart phones that use the Android operating system.
Android users who are blind and dyslexic can now use this application (app) to
access DAISY digital Talking Books anywhere without having to carry along an
additional single-purpose player. Darwin Reader for Android supports all
varieties of DAISY digital Talking Books, including DAISY 2 and DAISY 3 text and
audio formats, and the app is designed to easily transfer books from a computer
to a phone. The app also directly integrates with Bookshare, a source of
accessible books for people with print disabilities, to make finding new books
simple for qualified Bookshare members. The Darwin Reader is available on the
Android market for $3.95; a 30-day trial version is available, as well. For more
information, contact: Darwin Reader, New Designs Unlimited; phone: 888-868-6159;
web site: <www.darwinreader.com>.
Journal of Visual Impairment and Blindness. January, 2012, p. 54. Retrieved
from
http://www.afb.org/afbpress/pubjvib.asp?DocID=jvib060109.
***
In Memoriam
Robert “Bob” Dawson,
87, retired Military USMC, operator of the concession stand at Southwestern
Bell, 2nd and Main, Wichita, passed away December 20, 2011. Bob was preceded in
death by his wife of 40 years, Marie Dawson and a son, John Worthan. Survivors
include sons, Bruce Dawson of Liberty, MO, Mark Dawson of Colorado Springs, CO,
Greg Dawson of Chicago, IL, Kip Dawson of Wichita, James Worthan of Wichita, Tim
Worthan of Portland, OR, Mark Worthan of Oklahoma, Dave Worthan of Wichita;
sister, Dorothy Pond of Andover; 17 grandchildren; and 26 great-grandchildren.
www.hillsidefuneralhomeeast.com. Published in The Wichita Eagle from
December 21 to December 22, 2011
Gary L. Pope,
74,
passed away
January 23,
2012 at
St.
Francis Hospital in Topeka. He was born April 17, 1937
in
Pottawatomie County,
Kansas the son of William A. and Jean Delores Melenson Pope. He grew up in St.
Marys, graduated from St. Marys High School, and attended Washburn University in
Topeka. Gary served in the Kansas National Guard 174th Military BN, being
honorably discharged in 1995. Gary worked at the St. Marys Manor,
Topeka
State Hospital, Psychiatry Department, and McCormick's Carpet and Tile Company
in Topeka. He retired from the Rehabilitation Center for the Blind and Visually
Impaired in 2005.
Gary
lived most of his adult life in
Topeka.
He was a member of Holy Name-Mater Dei Catholic Church. He was married to Janice
Hasting in 1958 and later to Jane Dix. Mr. Pope was preceded in death by his
parents, a sister, Shirley Pope and a brother, James Pope.
Survivors
include his children Michael Thomas Pope and Karen K. Howard,
Lexington,
KY, and Steven Joseph Pope,
New Bern,
NC;
two brothers, William E. Pope,
Mission Viejo,
CA, and
Michael Joseph Pope,
Sacramento,
CA;
his sister, Mary Jean (David) Peterson, Wamego; and three grandchildren.
Memorial Contributions may be made to Holy Name-Mater Dei Catholic Church or
Mass Offerings and sent in care of Piper Funeral Home 714 Maple St, St. Marys,
Kansas 66536. To leave online condolences please go to
www.piperfuneralhome.com. Published in
Topeka
Capital-Journal on January 24, 2012.
Lowell
E. Holland,
86, Oklahoma City, died
January 27,
2012.
Lowell
was born
March 6, 1928,
to Ernest E. and Myrtle Holland in
Loraine,
Texas. He served in the United States Marine Corps, receiving the Purple Heart
for his service in the Korean War, where he lost his eyesight in frontline
combat. Lowell attended Bethany Nazarene College,
Oklahoma
University, and Texas Tech University, receiving degrees in social science,
educational counseling and guidance, and rehabilitation. Lowell worked for the
state of
Kansas
for over 30 years, serving as an administrator of the Kansas Rehabilitation
Center for the Blind in Topeka, Kansas. After retirement, Lowell and June
traveled extensively in their RV, and devoted time to work and witness trips in
Casa Robles, California, and Kenya, Africa. Lowell devoted his life to serving
the Lord and others through his service in rehabilitating the blind, and serving
in the
Nazarene
Church. He was a member of Fairlawn Church of the Nazarene while in
Topeka.
He received both the Outstanding Alumni Award and the "B" Award from Southern
Nazarene University. In his spare time, he enjoyed woodworking and creating
lamps, furniture, and other items
Lowell left
behind a legacy of Christian faith to his daughter, Cyndi Lackey, and husband
Lyndel, from Oklahoma, City; his three grandchildren, Jonathan, Juliana, and
Jace; as well as many family and friends who were touched by the positive,
strong spirit he portrayed. In lieu of flowers, donations may be made to the
Southern Nazarene University Scholarship fund. To share a memory or condolence,
visit
www.mercer-adams.com.
Published in The Oklahoman from January 29 to
January 30, 2012
***
Directors, 2012
Please send all
correspondence e-mail, surface mail, or phone contacts, to:
KABVI, 603 SW Topeka Blvd., Suite 304, Topeka,
Kansas 66603.
Telephone: 785-235-8990 or, in Kansas only,
1-800-799-1499.
E-mail:
kabvi@att.net. Web sites:
www.kabvi.com and
www.kabviyouthconnection.com.
Ann Byington,
President
abyington@cox.net
Beulah Carrington
b1car@sbcglobal.net
Bill
Moore
bmr@kni.ks.gov
Bob Chaffin,
Treasurer
chaffin@ruraltel.net
Henry
Staub
hstaub@cox.net
Joann
Vine
joannvine@sbcglobal.net
Jonathon Marcotte, Vice
President
jonathonmarcotte@gmail.com
Marilyn
Lind
ms.delta1976@yahoo.com
Michael
Byington
byington@cox.net
Mikel McCary, Membership
Secretary
mikel.mccary@gmail.com
Nancy Johnson, Recording
Secretary
supermom1941@sbcglobal.net
Paul Berscheidt, Webmaster
pberscheidt@kitusa.com
***
2012 KABVI Membership Application
___ Enclosed is $10.00 for my 2012 KABVI dues.
___
Enclosed is $250 for my Life Membership.
NAME:
____________________________________________________
ADDRESS:
_________________________________________________
CITY___________________________________ STATE:
_____________
ZIP: ________________ TELEPHONE: ( )
_______-_____________
E-MAIL ADDRESS:
____________________________________________
Are you: ____ Legally blind ____ Visually
Impaired ____ Deaf-blind ____ Sighted
I would like the KABVI NEWS and THE BRAILLE
FORUM in: ____ Braille ____ Large print ____ Cassette ____ Regular print ____
E-mail _____I do not want these publications.
I am including a tax-deductible donation to
KABVI in the amount of $_________._____.
SEND this form and your enclosed check to:
Robert Chaffin, Treasurer
1105 Centennial Blvd.
Hays, Kansas 67601.
***
Kansas Association for the Blind and Visually
Impaired
Esther V. Taylor Scholarship Supplemental Sheet
The Kansas Association for the Blind and
Visually Impaired (KABVI) will award two $1,000 scholarships to visually
impaired students enrolled in an academic, vocational, technical or professional
training program beyond the high school level. The KABVI scholarship committee
will accept applications from residents of Kansas enrolled in a college,
university or technical school. Material must be postmarked on or before April
15, 2012. Send the completed application and all supporting documents to:
Robert Chaffin, 1105 Centennial Blvd., Hays, Kansas 67601
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.
NOTE: Please DO NOT MAKE copies of this
application as committee members, who are blind or visually impaired themselves,
will be reading Xeroxed copies of your application using CCTV’s and/or scanning
software. To request additional copies of this material, call (800)-749-1499 or
e-mail
kabvi@att.net.
***
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 2012-13 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, 2012.
Required Documentation
To be considered for a
scholarship the student must submit the following items:
(1) 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:
Name:
_______________________________________________________
Address
______________________________________________________
County
____________________________
Phone
number ( ) _______-_______________
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)
_______________________________________________________________
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):
________________________________________________________________
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:
_______________________________________