Adult
Continuing
Education



Seminars@Hadley

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Adult Continuing Education

Enrollment Application

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Main information:

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Personal information:

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Is English your native language? *
Ethnic Background: *
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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
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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.