Silver Bells Program Application
This form allows blind and low vision seniors and their family members to apply for a scholarship to attend the Silver Bells Senior Training Program. It will also provide us with information we need to ensure that individuals attending the training program receive the training they need to live a more independent life. Instructions about how to use this form are listed below. Please follow these instructions carefully in order to make sure you receive the help you need to attend.

1. Everyone who wishes to attend the training program should complete this application form. If you do not need financial assistance, please answer "No" to the first question. Then, skip the questions related to financial assistance. If you need financial assistance, please answer all questions related to receiving financial assistance. Then, complete the sections that follow as well.

2. Please complete this application no later than July 7, 2017. Once we receive your application, we make contact in order to provide you with information about what assistance we are able to provide, if you requested it. If you did not request assistance, we will follow up with you as well. We will notify everyone about their status no later than July 8. If you apply prior to the deadline, we will make contact with you as soon as possible after we receive your application.

3. If you have questions or need help completing the application process, please contact Kayleigh Joiner, at 281-968-7733 between the hours of 9 AM and 5 PM, weekdays. If no one is available when you call, please leave a message. Kayleigh will return your call as soon as possible.

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