NFB EQ Application | National Federation of the Blind

Solicitud en español para NFB EQ.

NFB EQ (the National Federation of the Blind Engineering Quotient program) is a summer engineering program for blind and low-vision teens from around the United States. NFB EQ is jam-packed with fun and learning. Participants will have the opportunity to engage themselves in activities designed to strengthen their knowledge of engineering as well as their problem solving abilities.

This summer our NFB EQ Online will be held virtually from July 5-30, 2021. If you are a blind or low-vision teen currently enrolled in grades 9-12 in the United States and are ready to learn new things, meet new people, and have an adventure this summer we encourage you to apply to NFB EQ Online.

The deadline to apply is May 10, 2021. The cost of this program is free to participating families; however, if you wish to support our efforts in providing STEM opportunities please visit https://www.nfb.org/donate.

Student Information

Student's First Name *

Student's Preferred First Name - Optional

Student's Last Name *

Student's Gender *

What pronoun(s) does the student use? *

Student's Birth Date *

Each accepted student will receive materials to complete the NFB EQ online lessons at home. Please provide us with the address to which you would like your materials shipped. Please do not include a PO Box as we will ship via UPS.

Street Address *

Street Address 2 - Optional

City *

State/Province *

Zip Code *

Please make sure your phone number and email address are correct, as we will need accurate information to contact you. The phone number and email listed should be for the student applicant (not the guardian).

Student's Phone Number *

Phone Type - Optional

Student's Email *

Parent/Guardian Information

Parent/Guardian First Name *

Parent/Guardian Last Name *

Parent/Guardian Phone *

Phone Type - Optional

Parent/Guardian Email *

Parent/Guardian Secondary Email - Optional

What is the Parent/Guardian’s reading medium? Check all that apply. *

Braille

Large Print

Electronic

Background Information

Is the student currently enrolled in school or home schooled in the United States? *

What school grade level is the student in this spring (2021)? *

Please list any science, technology, engineering, or math (STEM) classes the student has taken in high school; as well as the student’s academic performance *

What is the student's level of interest in the following areas: science, technology, engineering, and math? *

What are the student's hobbies and what extracurricular activities does the student participate in? *

How did the student hear about this program? *

Why does the student want to attend the program? *

Medical and Vision Information

Please describe the student’s blindness/low-vision. Please include the student’s visual acuity (e.g., 20/200), visual field (e.g., 5 degrees), and the cause of your student’s blindness/low-vision. *

Does your student have any other special considerations (medical or otherwise) of which we may need to be aware during the virtual program? *

Additional Information

Does your family belong to an NFB affiliate? *

If so, which chapter? - Optional

If not, would you like to receive more information about joining the NFB from your state affiliate? - Optional

Has the student participated in any NFB sponsored events? *

If so, please name the event and the year the student attended. - Optional

Is your family registered to receive Future Reflections? *

If not, would your family like to receive more information about Future Reflections? It is a quarterly magazine for parents and teachers of blind children. - Optional

Is your family registered for NFB-NEWSLINE®? *

If not, would your family like to receive more information about NFB-NEWSLINE? It is a free audio service for blind and print disabled people with hundreds of publications. - Optional

Grant Reporting

The National Federation of the Blind pursues grant funding to support its programs, and some of these grantors ask us to describe the racial/ethnic/socioeconomic backgrounds of our students. In order to improve our program delivery and to respond to these requests, we ask you to answer the following questions.

Ethnicity *

East Asian or Asian Indian

Black, African American, or African

Hispanic, Latino, or Spanish

Native American or Alaska Native

Native Hawaiian or Other Pacific Islander

Other

Prefer not to answer

White

What is the approximate average annual household income for the student’s primary residence? *

Media Release

NFB EQ Online is a virtual program. If selected, you are welcome to send us your photos and videos of your child’s or your (if 18 years of age or older) participation in the program.

Do you give permission for the National Federation of the Blind (NFB) to use your and/or your child’s image or likeness in materials produced by the NFB for promotional and educational purposes or for any other purpose and in any manner and medium, including, but not limited to, the following: print materials, websites, social media and news media? *

NFB Discharge

If selected, I give permission for my child or myself (if 18 years of age or older) to participate in the National Federation of the Blind (NFB) EQ and EQ convention events and activities. I have read and understand the questions and information on this application form, and have answered the questions truthfully to the best of my knowledge. *

Upon submitting this form your responses will be saved, and you will receive an email copy of your responses. We will notify you if your student is accepted into the program. For additional questions or concerns please contact us at [email protected] or by phone at 410-659-9314, extension 2418.