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CA School for the Blind

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CA School for the Blind

    California School for the Blind Department of Rehabilitation

    Course Description of the

    SUMMER TRANSITION EDUCATION PROGRAM 2006

    Session: July 9 28, 2006

The Summer Transition Education program (STEP) is a cooperative venture between the

    State Department of Rehabilitation and the California School for the Blind. Participants in this program are public high school students or graduates from public school, ages 16 21. Students

    must be clients of the Department of Rehabilitation.

Enrollment is limited to 14 students who reside in the CSB Apartment Complex.

Classes/activities begin at 7:30 a.m. and end at 10 p.m. Monday Friday. Weekend skill building

    activities begin at 9 a.m. and end after 10 p.m., depending on the stamina of students and staff.

    The program focus is on Career Awareness/Exploration, Computer Technology, Daily Living Skills and Orientation & Mobility. Also scheduled are experiential trips to the Orientation Center for the Blind in Albany, Living Skills Center in San Pablo, Guide Dogs for the Blind in San Rafael and a Job Shadowing Experience. Weekend experiences allow students time to enjoy the Bay Area’s recreation/leisure options (i.e.: kayaking, tour of Alcatraz, Golden Gate Park) while putting into practice skills learned in the daily classes. Using public transportation, use of money, team work, etiquette and socialization are just a few of the skills practiced during the weekend activities. Students must participate in all classes, seminars and activities. We do not offer optional classes, seminars or activities.

    Seminars/recreational activities are offered during the evening hours which may include, but are not limited to: Learning about funding sources, SSI, Social Skills, Decision Making, Science, Art, Music, Swimming, Dance Therapy, Self-Defense, Mall Exploration, etc.

    All students are encouraged to participate in the final activity of the program, a Talent Show. Students may sing, play an instrument, recite poems and readings, perform a comedy routine or a dramatic story or be a part of the audience.

    There are scheduled activities for the weekend or students may select an activity. If the activity is more expensive than the offered event, students pay a portion of the cost to affect change. There are no other costs to students or family.

     (Do not return this page with application)

    CA School for the Blind Department of Rehabilitation

    STUDENT APPLICATION FORM

    SUMMER TRANSITION EDUCATION PROGRAM(STEP)

    Session: July 9 28, 2006

Instructions:

    Fill in all lines, if not applicable write N/A

    The application has 6 pages, be sure to return all pages

    Please do not do any medical requirement until you receive a letter

     of acceptance. There have been times when we have had more

     applications than placement positions.

    You must obtain your Rehab Counselor’s signature to apply

Student’s Name ________________________________ Age _______

    Date of birth ______________________ Place of birth________________

    Social Security Number ___________________ Sex: Male Female

    Home Address ____________________________________________________

    Home Phone_____________________ Emergency Phone # ________________

Parent/Guardian’s Name ____________________________________________

    Home Address/City (include zip code) __________________________________

    ________________________________ E-mail address________________

    Home Phone _____________________ Work Phone _________________

VI Teacher’s Name ______________________ Phone _________________

    -1-

    Cause of Visual Impairment__________________________________________

    Age at onset of legal blindness___________ Prognosis___________________

    Visual Acuity: right (OD):_______ left eye (OS)________ Both (OU)_______

    Field Restriction: No ______ Yes______ Type___________________

    Assistive Devices: No _____ Yes______ Type ___________________

    Other impairments (please list) _______________________________________

    Physical restrictions ________________________________________________

    Physical/Assistive needs: attendant _____ guide dog _____ walker____

     wheelchair ___ other ___ (________________)

    Medical Needs ____________________________________________________

Are you taking medication? Yes_______ No _______

    If yes, list ________________________________________________________

    What is the medication for? ______________________________________

    Do you need help with your medication? Yes ______ No ________

    If yes, what type of help do you need?__________________________________

    Special Meal Accommodations? Vegetarian: Yes______ No______

    Allergies? _________________________ Motion Sickness Yes _____ No ___

    List the classes you are presently taking________________________________

    ________________________________________________________________

    -2-

Grade in School as of Fall ’05 ______________________

    What media do you use? Braille ______ Large Print _____ Tape_____

Do you use grade two Braille? Yes_______ No_______

Do you use a slate and stylus? Yes ______ No ______

    What is your vocational goal?_________________________________________

    What are you planning to do after high school graduation?

     Trade School ________________________________________

    Community College____________________________________

    4 year College________________________________________

    Other (Explain)_______________________________________

    Don’t Know __________________________________________

    If you plan to go to college, which college or university do you plan to attend?

    ________________________________________________________________

    Which college or university has accepted you? ___________________________

What careers are you interested in job shadowing?

     st1 choice ____________________________

     nd2 choice ____________________________

     rd3 choice ____________________________

    Do you play an instrument?______ sing ______ dance ______

    -3-

    Do you read or write poetry? _____ Do you read or write short stories? ____

    What sports do you play? ___________________________________________

    What sports do you watch? __________________________________________

    We offer the following classes: Daily Living Skills, Computer Technology, Career Awareness/Exploration and Orientation & Mobility. Classes, seminars and activities are not an option, students are expected to participate in all classes, seminars and

    activities.

If you do not need to learn any additional skills or refinement of skills in all of the

    above areas, this is not the program for you.

     List 3 skills you have List 3 skills you need

    Career Awareness/ 1. 1.

    Exploration 2. 2.

    3. 3.

    Computer Technology 1. 1.

    2. 2.

    3. 3.

    Daily Living Skills 1. 1.

    2. 2.

    3. 3.

    Orientation & Mobility 1. 1.

    2. 2.

    3. 3.

    We also have evening seminars that include, but are not limited to the following: social skills, social security needs, time management, dance therapy, self-defense, science, art, etc.

    Additional comments from VI teacher or RCB: Continue on back, if needed:

    ___________________________________________________________________________________________________________________________________________

    -4-

    We ask students to bring clothing appropriate for school. No tank tops, short shorts, or low cut tops or dresses. Clothing must be free of profanity, slurs, sexual, drug or drinking innuendos. You need at least 1 dressy outfit for your Job Shadowing experience. Weather is usually warm, but bring at least 1 coat in case of cold weather. Your shoes should be comfortable for walking because you will be doing a lot of walking.

    We hope to have a kayaking experience one weekend which includes staying overnight at Angel Island, if arrangements can be made. This is not an optional

    event. Bring a sleeping bag unless you are flying, we have a few (limited) available.

Very Important Note:

    1. Upon acceptance into program you must provide a copy of your TB test

    taken within six months of entry into program. Test must be taken after January

    12, 2006. If must be a PPD (Mantoux) test. You must mail proof of test before

    you arrive for the program.

    2. You must sign the medical authorization form and return it.

    3. All medication must be in its original bottle/packet with instruction on the

    container.

     st 4. All medication must be taken to the Student Health Unit on the 1Monday of the

    program.

    5. If you are over 18 you may ask your physician to sign the self medication form

    that states you are able to be responsible for your own medication. If you are

    over 18, the parent signature is to note acknowledgement that you have

    discussed the form with them.

     Students: Talk to your Counselors about authorized spending money.

    RCBs: Per Rehab contract: Please authorize $100.00 for spending money

     for client.

    -5-

    Applications are due by April 17, 2006. Acceptance will be announced by April 30, 2006.

    _________________________________________________________________ Rehabilitation Counselor’s Signature

    _________________________________________________________________ Rehabilitation Counselor’s Address/City (include zip code)

    _________________________________________________________________ Rehabilitation Counselor’s Phone Number

    _______________________________________________________________________ Rehabilitation Counselor’s E-mail address

Return your completed application and letter to:

     California School for the Blind

     Attn: LaVernya K. Carr, Transition Principal

     500 Walnut Avenue

     Fremont, CA 94536

Any questions: (510) 794-3800 X262

     (510) 794-3813 (fax)

     lcarr@csb-cde.ca.gov (E-mail)

    Please attach a one page letter explaining why you want to attend the Summer Transition Education Program and something about yourself.

    -6-

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