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
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 _________________
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________________________________
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 ________________________________________
4 year College________________________________________
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 ______
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
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.
Computer Technology 1. 1.
Daily Living Skills 1. 1.
Orientation & Mobility 1. 1.
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:
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
st 4. All medication must be taken to the Student Health Unit on the 1Monday of the
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
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)
Please attach a one page letter explaining why you want to attend the Summer Transition Education Program and something about yourself.