Become a MindsEye Listener

MindsEye Listener Application

MindsEye’s Broadcast Information Program is specifically intended for individuals who are blind, partially sighted, or have a print disability.

"*" indicates required fields

Listener Name*
Address*
Email
How would you like to listen to MindsEye's broadcast?*
Would you like to receive information about other MindsEye programs?
Would you like to be added to our email list for newsletters and announcements?
How did you hear about MindsEye?

Program Schedule and Other Information Format
There are several formats available. Which one do you prefer?

Eligibility Requirement

MindsEye's Broadcast Information Program is specifically intended for individuals who are blind, partially sighted, or have a print disability.*
Please select the option that best describes your disability.

Secondary Contact Information

Please provide contact information of a family member, friend, or caregiver.
Secondary Contact Name
Secondary Contact Email

Demographic Information

Answers remain confidential and are not used to determine service eligibility. This information is used anonymously and demonstrates that we serve a diverse audience as required by authorized funders, like the United Way.
Gender Identity*

Ethnicity (check all that apply)*
Are you a veteran?*
Are you a member of the LGBTQ+ community?*
Annual Household Income*
I have electronically signed on the space below or have personally requested this service and authorized that this application be signed on my behalf. I confirm that I meet the eligibility requirement to qualify for MindsEye’s service. If loaned a radio or Echo Dot, which is the property of MindsEye, I will return said device when I no longer need the service.
This field is for validation purposes and should be left unchanged.