Cerebral Palsy Research FoundationP.O. Box 8217 5111 East 21st Street Wichita, Kansas 67208 Phone: (316) 688-1888 Fax: (316) 688-5687 E-Mail: info@cprf.org Cerebral Palsy Research Foundation
P.O. Box 8217 5111 East 21st Street Wichita, Kansas 67208 Phone: (316) 688-1888 Fax: (316) 688-5687 E-Mail: info@cprf.org
School of Adaptive Computer Training More About CPRF News Online CPRF Employment Opportunities CPRF Services | Customized Wheelchairs and Repairs | Work Site and Home Modifications | Transportation | Housing | Adult Day and Learning Programs | Case Management CPRF Research Kansas Benefits Counselors Network CPRF Advocacy Join the CPRF Team KS disAbility Tool Contact Us Table of Contents

Bobby Approved (v 3.2)


 


 P.O. Box 8217 5111 East 21st Street Wichita, Kansas 67208 Phone: (316) 688-1888 Fax: (316) 688-5687 E-Mail: info@cprf.org
School of Adaptive Computer Training
Short Application Form

Congratulations on taking the first step toward training for a new career.  Filling out the Short Application Form below will bring you into contact with one of our SACT recruiters.  Once you complete the form, you can submit it online by selecting the "Submit" option.  If you would rather print a blank form and mail it, select the "Print a Blank Form" option at the bottom of the page. Please mail or fax your print copy to:

CPRF School of Adaptive Computer Training
5111 E. 21st St.
Wichita, KS 67208

* Required Fields

*Name 

*Address 

Address 2 

*City 

*State 

*Zip 

*Phone 

Email Address (if you would like an email response)
   

*How did you hear about the SACT? 

   
*Do you have a high school diploma or a GED? Yes
No
   
*Do you have a disability? (People with all disabilities are eligible to apply.) Yes
No
   
*Can you communicate effectively -- with or without adaptive equipment? Yes
No
   
*Will you accept full-time employment? Yes
No

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