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Application Instructions & Forms

Educational Services for Blind and Visually Impaired Children - Application child with book (braille).Upon receiving a referral, a supervisor will review the eye report to determine if the eye doctor has indicated that the child has a visual impairment. If so they will be referred to a Teacher of Blind & Visually Impaired Children (TVI) from ESBVIC who will conduct an assessment of functional vision, review the educational implications of the visual impairment, and present recommendation for services to the IEP, 504 or IFSP team.

If services are needed, the type and amount of services are identified in the Individualized Education Plan (IEP) or the 504 Plan. Recommendations for the type and amount of services from ESBVIC for pre-school children are identified in the Individualized Family Services Plan (IFSP). The applicant may be referred to the Maine Division for the Blind and Visually Impaired for other programs or services as necessary. DBVI would contact you regarding any of these services.

Please complete and return ALL of the following documents to ensure your application process moves as quickly as possible:

  • Completed and signed application packet (PDF)

  • A recent medical eye report from either an optometrist or ophthalmologist

    Please note: We must receive the medical eye information prior to any student visit. If you do not have an eye report, ESBVIC will request the  report. Please make sure all releases are signed and submitted with application.
  • Please review our Privacy Practices page

CC MAine Education Services for Blind & Visually Impaired Children - ApplicationApplications may be faxed to: (207) 282-1694 or mailed to:

Nancy Moulton
ESBVIC Program Director
P.O. Box 645
Biddeford, ME 04005

If you have any questions, feel free to call us at 207-299-1936 or toll free 1-888-941-2855.

Maine’s Division for the Blind and Visually Impaired (DBVI) is mandated to provide services to children (birth through 20 or the completion of high school) with a vision impairment affecting their ability to learn. Education Services for Blind & Visually Impaired Children/Catholic Charities Maine (ESBVIC/CCME) is contracted by DBVI to provide these education services. Teachers of Blind and Visually Impaired children (TVI) employed by ESBVIC provide the following: assessment of vision and corresponding implications for learning and direct teaching and/or consultation to schools and families. TVIs providing services to children are part of the Early Childhood Team (ECT), the Individualized Education Program (IEP) team, or the 504 process.