Please complete the application and return to the LightHouse by Monday, March 16, 2015.
For youth over the age of 18, please provide emergency contact information below. If you are under 18 years of age, please provide your parent/guardian information:
If yes, who is your counselor? (Please be sure to ask your DOR counselor to approve your attendance at the Leader’s Summit and then have them forward an Authorization to LightHouse for the Blind.)
Please consider the following questions carefully. Answers must be at least 50 words long.
Before submitting your application, please check the box below.