AMERICAN COUNCIL OF THE BLIND OF OHIO
MEMBERSHIP APPLICATION




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Online Membership Application



First Name :

Last Name :

Address :

City :

State :


Zip Code :

Phone : Example 321-222-2232

Email :

the legal definition of blindness is defined as being: 20/200 or less in both eyes with
correction, or a visual acuity of less than 20 degrees in both eyes.

Are you blind or visually impaired according to the legal definition of blindness?
Yes
No

CHAPTERS :


WHICH CHAPTER WOULD YOU LIKE TO BE A MEMBER OF?
SELECT ONE.


Media type:

Media type for Braille Forum newsletter :


Media type for the Ohio Connection newsletter:


Annual dues are $15.00 Please mail your check or money order to:
ACB of Ohio
P.O. Box 307128
Gahanna, Ohio 43230

For more information about membership please contact:
Membership Committee Chairperson
Phone: (937) 361-6909
Email Membership Committee Chairperson


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