Adult Continuing Education

Enrollment Application

*Indicates a required field for students

Main information:

Choose gender: *

Personal information:

Is English your native language? *
Ethnic Background: *
Please enter background

In order to provide materials to you free of charge, we need to document to funders that we are specifically serving those with visual impairment. The following questions are to fullfill our responsibility in this regard:

What is your eye condition? *
Does vision loss significantly affect your daily living? *
Vision in each eye (if known):
What was your age at the onset of your visual impairment? *
Are you hearing impaired? *
Do you have a disability in addition to vision loss? *
Please select yes or no
Please enter disability
Do you have a DTB player? *

By selecting Submit below, you are agreeing to the following:
1) Your willingness to connect Hadley with an eye care or other professional who could document your eye condition should we require further information.
2) Your commitment to respect the copyright of Hadley materials and understand that they are not for resale.
3) The terms and conditions of our privacy policy.