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NOPBC Conference Registration
What is your primary role? (select all that apply)
*
Parent/Guardian
Teacher
Friend of the NOPBC
Other
First Name
*
Last Name
*
Street Address
*
Supplemental Address
City
*
Country
*
- select Country -
United States
State
*
- select State/Province -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
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Nebraska
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New Hampshire
New Jersey
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New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
United States Minor Outlying Islands
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip/Postal Code
*
Email Address
*
Cell phone number (to be used at convention)
*
Additional Adult Name(s)
Do you have a blind/low vision child/ren?
*
- select Do you have a blind/low vision child/ren? -
Yes
No
If yes, please list name and age of each, and whether each child will be coming to convention.
Youth Track registration for children ages 11-18 Youth Track registration for children ages 11-18 (Please list names, ages, Youth email, and Youth phone.)
Is this your first convention?
*
- select Is this your first convention? -
Yes
No
If you require any disability-related accommodation in order to participate in the NOPBC Parent Conference at the 2023 NFB National Convention, please let us know by May 31, 2023
Registration Fee(s)
Registration Type
Individual
-
$ 35.00
Family
-
$ 50.00
- none -
Total
Payment Options
Payment Method
Paypal NOPBC
I will send payment by check
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