If you are a parent, guardian or caregiver applying on behalf of a child or somebody else, please give the details of the applicant below.
Please use the section below to give details about the items and/or services you wish to request as part of your application. Please give as much information in respect of how these items would be of benefit to you, with an emphasis on your visual impairment and the positive impact they will have.
Before submitting, please confirm that you have read, understood and accept our Privacy Policy and ensure that the information given above is accurate.
Please correct the following errors.