Transition Talks Registration Form Transition Talks Form Attendee * Attendee First Name First Name Last Name Last Name Email * Phone * Address * Apt/Unit City * State * IllinoisAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Age * Grade in fall 2026 * Guardian (if under 18) Guardian (if under 18) First Name First Name Last Name Last Name Relationship to Attendee Emergency Contact * Emergency Contact First Name First Name Last Name Last Name Relationship to Attendee * Emergency Contact Phone * What is your current level of vision? * Fully blind (no usable vision) Low vision (some usable vision) I use assistive devices (e.g. glasses, magnifiers) to support my vision I have other vision challenges (please specify) *If you selected fully blind, please note: Transition Talks are specifically designed for individuals with low vision. While we are committed to supporting all participants, those who are fully blind will be considered on a case-by-case basis, and appropriate accommodations will be discussed. *Please be aware that we may not have specific resources such as braille materials or a one-on-one staff ratio to assist participants with no usable vision. Our goal is to create an environment that best supports those with low vision. If you are fully blind, please reach out to discuss how we can best meet your needs. Other vision challenges: Do you require any specific support or accommodations to ensure a positive Transition Talks experience? (If none, please indicate "none.") * Are there any medical or additional needs we should be aware of to provide the best care for you for the day? (If none, please indicate "none.") * Transition Talks topics can include any of the following. Please indicate which topics you are specifically interested in Access Technology Phone Apps Social Media (content creators with low vision) Transportation (Driving &/or Public Transportation) Self-Advocacy in College/Scholarships Kitchen Tips Self-Advocacy in Life IDHS State Services Is there anything within these topics that you have specific questions about? Lunch and snacks will be provided. Do you have any dietary restrictions including food allergies or sensitivities? * How did you hear about Transition Talks? * Facebook/ Instagram Website Flyer Word of Mouth Vision Teacher I give permission to be photographed by Spectrios Institute and grant the right to use photographs for marketing efforts * Yes, I can be photographed. No, do not photograph me. Would you like to sign up for our newsletter and keep up with all the happenings at Spectrios Institute for Low Vision? * Yes, I would like to sign up for the newsletter. No, thank you. Submit If you are human, leave this field blank.
