Register

In order to benefit from our full range of services you must be registered with us. Before registering, please check that you are eligible by reading the information below. If you are ineligible but require support, please do not hesitate to contact us as we may still be able to help you by offering advice, guidance or signposting you to another organisation.

You are eligible to benefit from our services if all of the following applies to you.

You are registered or are registrable as sight or severely sight impaired
You are aged 29 or under
You are a permenant resident within Sussex

Generally, the simplest way to register with us is by completing the form below. However, if you are unable to register online or require assistance in order to complete the form below, please contact us.

About you

If you are a parent, guardian or caregiver registering on behalf of a child or somebody else, please give the details of the registrant below.

Title*

Forename*

Surname*

Alias

Gender

Birth date*

Referral

If your registration is on behalf of the registrant in the form of a referral from a third-party, such as the local authority, school or similar organisation, please give details below.

Your name

Organisation

Your job title

Please give any additional details regarding the nature of the referral and any other information you feel may be relevant.

Contact details

The details given below will be used to make contact with the registrant. If you are a parent, guardian or caregiver registering on behalf of a child or somebody else, please specify your name and relation to the registrant. If left blank, the registrant's name given above will be used to make contact.

Name

Relation

Address line 1*

Address line 2

Town/City*

County*

Postcode*

Telephone

Mobile

Email*

Sight Impairment

Please try to provide as much detail as possible as this will help us to assess how best to support you.

Eye condition*

Registered as

Severity*

Please give details specifically relating to your eye condition(s). It's helpful for us to understand the impact your sight impairment has on various aspects of your life e.g. independence, mobility etc.*

Please give details of any other disabilities you have other than your eye condition(s). You are not obliged to disclose information about any additional disabilities, however we use this information to help us better understand how best to support you.

Education

If you (the registrant) are of school age, at college or university, please give details. In some cases it may necessary to make contact with the educational establishment in order to provide support.

Name of school/college/university

Year joined

In some cases you (the registrant) may have an allocated QTVI (Qualified Teacher for the Visually Impaired). If so and if known, please give their name below.

Please give any further information you may feel appropriate relating to the school, college or university.

Employment

In some cases we may be able to offer advice and/or information to support you in your place of work. Alternatively, if you are currently unemployed, we may also be able to support you in your search for employment. We will not contact your employer without your consent.

Employer

Role

Year joined

Details

Further information

Please use this section to tell us about yourself and any specific needs you have and wish to disclose or particular areas of support you require. This section helps us to get to know you and how best to support you.

Details

Privacy and terms

Please give your agreement to the following terms and conditions.

Please check this box if you have carefully read, understoodd and accept our Privacy Policy.*

Please check this box if you wish to join our mailing list to receive updates about upcoming events, news and other information.