WIHD Make It Request Form - Westchester Institute for Human Development

I am interested in a creation for:

Myself

Another person

I am looking for (check all that apply):

Learning Support – Reading bar / Switch

AAC – Keyguard (see additional form)

Clothing. Personal Self-Care Tools – Nail clipper Assist / Button Hook / Zipper assist

Special Furniture – Door handle / Key turner

Modified Kitchen Tools – Bottle opener/Can opener

I found an SLT file for something can you make it

AAC – Keyguard

What model number name is your iPad (example iPad 9/iPad Air3)?

What case are you using?

What is the millimeter measurements of the height and width of the inside of the screen that is exposed?

Please include a screenshot of the app home screen and photographs of the front and back of the iPad in the case. (if having issues with uploading images, please email them to gwhite@wihd.org).

Maximum file size: 516MB

I am mostly interested in tools and technology for (check all that apply):

Vision Loss

Talking and Communication

Learning and Thinking

Deafness and Hearing Loss

Physical Challenges

Email

Phone

This item will be used for (check all that apply):

Education

Employment

Community Living

Address

City

State/Province

Zip/Postal

County in New York

reCAPTCHA

Name

First

Last

The item(s) was/were obtained because:

I could only afford through this program

It was only available through this program

It was available through other programs but the system was too long and complex

Is there anything else you want us to know?

How did you hear about WIHD MAKE IT?

Person you are referring to WIHD MAKE IT

Person Needing Tools / Tech

First

Last

My Relationship with this Person

Age of Person Needing Tools/Tech (in years):

Phone Number for Person Needing Tools/Tech

Email for Person Needing Tools/Tech

Should we use your address and contact information for this person?

Yes

No

Address of Person Needing Tools/Tech

City

State/Province

Zip/Postal

Country