CCB Summer Youth Application
We are offering two summer residential program options in 2024, as described below. Of course, please contact our Director of Youth Services, Chaz Davis if you have any questions at cdavis@cocenter.org or 303-778-1130, ext. 212.
Sign in to Google to save your progress. Learn more
Who is filling out this Application? *
Option 1.

Summer For Success 7-week program:

Dates: June 21 through august 9, 2024

This longer program will provide each student with additional instruction to cement their skills and confidence. Students enrolled in this seven-week program will attend the annual National Convention of the National Federation of the Blind held in Orlando, Florida from July 3 to July 8. They will learn techniques for airport travel, how to navigate a large hotel, a wide array of technology, meet blind people, attend meetings to learn more about the NFB and much more.

To participate in this program applicants must be 16 years of age or older. They are required to submit an essay discussing why they want to attend the national convention. 



No Limits to Learning 
4-week program:

Dates: July 12 through august 9, 2024

This program is open to applicants who are 15 years old and up. Except for attending the National Convention, this shorter  program will cover all elements  listed above, including challenge recreation activities. 

Select which program you are applying for: *
Student's Name *
Student's Email *
Student's Phone Number *
Student's Date of Birth *
MM
/
DD
/
YYYY
Student's Address *
If you live in Colorado which county do you live in?
Parent/Guardian Name *
Parent/Guardian Email
Parent/Guardian Phone Number *
Name/Email of Student's Teacher of the Visually Impaired (if applicable)
Name/email of Student's Vocational Rehabilitation Counselor (if applicable)
Student Demographic Information
We collect voluntary demographic information that we are often asked to provide for grants to support our Youth Programs. The information you provide here is considered private and will not be shared or made public, except in aggregate numbers. Nor will it be used in considering your application.
Student's Race / Ethnicity
How do you self Identify? Select all that apply:
Student's Gender
Clear selection
My family's overall income is:
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report