There is a reported problem on some systems with this form. The submit does not always work. If you click submit and you are not taken to your email program please do the following.
Use Control P and print the screens. Put the output and your check in and envelop and mail to:
Arizona Council of the Blind, Inc. 3124 E. Roosevelt St., Ste. 4 Phoenix, AZ 85008-5088
Sorry for this problem and I will remove this message when I determine the solution. Thank you very much for your understanding.
MEMBERSHIP APPLICATION
Membership in the Arizona Council of the Blind is an adventure we want you to share. We hope you will get involved.
The Arizona Council of the Blind gives you a voice in our state and nation. Come, take our hand, and join our adventure.
Fill in the form below and submit and we will send you a Self Addressed Envelope. Just put your payment in the envelope, seal and send it back and you will be a member of the Arizona Council of the Blind and the American Council of the Blind.
Payment for new members of the Arizona Council is $10.00. Renewal fee is $10.00. Is this a renewal, update to data, or a new member application? Renewal Application Update Member Application New Member Application TODAY'S DATE (MM/DD/YYYY): BIRTHDAY (MM/DD/YYYY): Check one: Title is Mrs. Ms. Miss Mr. Name: Address Line 1: Adress Line 2: City: State/Province: ZIP Code/Postal Code: Telephone: Phone AREA CODE: Phone NUMBER: Email Address: OCCUPATION: Vision - CHECK ONE: Vision is Sighted partially Sighted Blind
NEWSLETTER PREFERENCE For Fore-Sight (newsletter of the Arizona Council) Check one: Large Print Audio Tape Do Not Send ACB BRAILLE FORUM (newsletter for NATIONAL) check one: Computer Disk Large Print Audio Cassette Tape Braille Do Not Send
Submit will send an E-mail of this form to the AZCB. If you are asked for an address please use tom@azcb.org Click here when your information input has been completed
---- Arizona Council of the Blind Home Page.