Sign Up for LightHouse Programs

* These fields are required.


From expert skills training to fun one-off events, LightHouse offers a range of workshops, activities and services for individuals with eyesight of all levels. We collect information about all of our students in order to determine general eligibility for services and ensure we tailor our programming to specific needs.

If you need a trained LightHouse staff member to help with the sign-up process, give us a call at (415) 694-7323.

Note: Your responses are confidential and will only be seen by qualified LightHouse staff.

If you are referring someone else, please answer the questions as best you can on behalf of the person you are referring. We will need to talk to them directly so that we can assess if they are ready to move forward with our programs.

Contact Information


Mailing Address


Emergency Contact Info

If you are under 18, your emergency contact MUST be a parent or guardian.

Vision, Hearing and Health Info


Do any of the conditions listed above affect the following:

Program Interest


Demographic Information

Please complete the questions below. If you choose not to disclose some of this information, simply select 'Declined' from among the drop-down options. Demographic information is collected to help in funding our programs and making our services as inclusive as possible. All responses will be kept confidential and only reported in the aggregate. Thank you!

Stay Informed

Want to stay in the loop about news, opportunities and exciting developments at the LightHouse?

Referring someone else?


* Legal blindness is a level of vision loss that has been legally defined to determine eligibility for benefits. The clinical diagnosis refers to a central visual acuity of 20/200 or less in the better eye with the best possible correction, and/or a visual field of 20 degrees or less.

** A veteran is a person who served in the active military, naval, or air service, and who was discharged or released there from conditions other than dishonorable.

 

 

 

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