Listed below are forms and applications for some programs in the Division of Service to the Blind and Visually Impaired. If you wish to apply for a program service, please download the application in either Microsoft Word 97 or Adobe Acrobat format, print the application, complete and sign the relevant application and mail to the division central office.

Department of Human Services
Division of Service to the Blind and Visually Impaired
3800 East Highway 34
c/o 500 East Capitol
Pierre, SD 57501-5070

The following forms are available in two formats. Microsoft Word 97 will require either Microsoft Word 97 or newer or another word processing program that can convert this format. Each form/application is also in the Adobe Acrobat Portable Document Format (PDF). This format requires that you have the Acrobat reader on your computer.

Click here to download the Adobe Acrobat Reader.

For those using accessibility aids, such as screen readers, click here to download an accessible version of the Adobe Acrobat Reader.

Application for Vocational Rehabilitation Services: This form is to be used to apply for SBVI Vocational Rehabilitation Services.
VR Application MS Word 97
VR Application PDF

Application for SBVI Independent Living Services: This is the application to be used for the Elderly Blind and Rehabilitation Teaching Independent Living Programs within SBVI.
Independent Living Application PDF

Radio Talking Book: This is the form to be used to apply for the Radio Talking Book Program and a talking book radio. This is a special radio that receives the talking book radio signal.
Radio Talking Book Application Word 97
Radio Talking Book Application PDF

SD News Telephone Reader: This form must be completed in order to apply for access to several South Dakota newspapers and other publications via the SD News Telephone Reader system.
SD News Telephone Reader Word 97
SD News Telephone Reader PDF