Arizona Council of the blind LOGO.  A Yellow Sun behind Green Cactus the letters A Z C B on the sun.

Arizona Council of the Blind, INC.
16845 N 29th Ave, Suite#139
Phoenix, AZ 85053
(602) 273-1510


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.

Instructions for Completing the AzCB Membership Application

  1. Read the screen completely, maybe line by line, so you know what is going to be requested. Turn off Browse mode and go into forms mode. Tab through the form filling in all requested data.
  2. Use Submit Button to continue.
  3. You will receive the screen to make your dues payment.
  4. Make your dues payment using PayPal, credit card, or mail check or money order to the address given.

If you have comments, please use the comment field on the form to leave a note of less than 240 characters for the AzCB. Thank you for your interest and if you have any questions or need help please email the webmaster.

Fill in the form below and submit.

Application Type Selection

Is this a renewal or a new member application? (select one):

 


Selection of Affiliates for membership dues

There are several Affiliates which you can join to be in a group with more focused issues and with extra social activities. You must check the AzCB box if you are not a member for the year you are filling the application out for. If you wish to be in any or all the Affiliates, check the box for that group. The amount field is the total of all the boxes checked. This is the amount you will put in the PayPal field.

Dues is the sum of State (AzCB) Membership plus the dues charged if you wish to also be a member of one or more Affiliates. Here is the listing of how much items costs:

Select your affiliate options:



Total all the boxes checked and put amount here ($10.00 just the State Membership to $33.00 for all the Affiliates)

 

Contact Information

 

 

 

 

 

 

 

 

 

 


Vision Status

 


Newsletter Format Preferences

You are able to receive both the State and National newsletters. In this section of the application, you can select the format type for each newsletter.

Arizona Newsletter (Fore-Sight)

 

National Newsletter (Braille Forum)

 


Payment Type

 


Miscellaneous Questions and Comments

 


Submit your application

Submit will send an E-mail of this form to the AZCB.

Return to AzCB Web Site