Welcome to the online application for Adaptive Technology Grants. Please fill in all fields. If you have questions or need help, please contact the office at (314) 832-7172 or by emailing email@example.com
Please note, you will need to submit the following:
A. The exact specifications of the adaptive technology or computer to be purchased.
B. A copy of an official price quote from two (2) vendors
C. Written verification of legal blindness from an Ophthalmologist or other reasonable authority (obtained within the past year) including a description of the applicant’s eye condition, visual acuity and field of vision.
Please read and indicate your acceptance by signing and dating the end of the form.
Statement of Agreement
I have read the entire document titled “Missouri Council of the Blind Adaptive Technology Grants Program,” and I understand and agree to all terms and conditions contained therein. All information that I have listed on this application form is accurate to the best of my knowledge and correct to the best of my ability. I understand and agree that any failure on my part to wholly comply with the “Missouri Council of the Blind Adaptive Technology Grants Program” or “Missouri Council of the Blind Adaptive Technology Grants Application Form” may void this application or otherwise render me ineligible for a MCB matching funds grant.