Mid-Atlantic American Council of the Blind

Affiliates’ Regional Convention

November 2-4, 2007

Registration Form

 

NAME:

PHONE:

E-MAIL:

ADDRESS:

Program Format Preference:

__ Braille   __Large Print   __DISC (Text & Word Document)

Saturday Afternoon CONCURRENT SESSIONS: 

Please check the sessions you plan to attend.

Session 1: 1:15 – 2:00 p.m.

___ A: Regaining Independence – Support Groups

___ B: Education & Blind students (IEPs, college resources,etc.)

___ C: Finding a Job (resources for the job hunter)

Session 2:  2:15 – 3:00 p.m.

___ A:  Technology Training

___ B:  Dr. Khan, General health and blind/visually impaired people 

___ C:  Getting a Job (resumes, applications, and interviews)

Session 3:  3:15 – 4:00 p.m.

___ A:  Is a Guide Dog Right for You?

___ B:  Volunteers and Readers etc., Who is coordinating them?

___ C:  Dr. Alibi, Low Vision options

Session 4:  4:15 – 5:00 p.m.

___ A:  Experienced Guide Dog Users

___ B:  Families & Friends of Blind Network 

___ C:  VDBVI Open Hearing

REGISTRATION - $40.00, $45 if after 10/15/07   $_____

Includes Canes, Canines, and Cocktails Reception

on Friday evening, Coffee both mornings, Annual

Banquet, and convention materials.  Other meals

may be included by sponsors but are not yet confirmed. 

Check here if you require vegetarian meals        _____

 

SUPPORTER (Optional)       $_____

I wish to become a Gold Supporter ($50), or a

Silver Supporter ($25) or make an additional gift

to help with the fine programs of these organizations.

DUES: For your convenience, you may pay your annual dues for the upcoming year to your designated affiliate(s) below.

American Council of the Blind of Maryland ($15)    $_____

    ___    CMCB - Baltimore

    ___  NCAC – Silver Spring

District of Columbia Council of the Blind ($10)    $_____

Maryland Area Guide Dog Users, Inc. ($15)    $_____

National Capital Citizens w/ Low Vision ($20, Seniors $15)$_____

Old Dominion Council o/t Blind & Visually Impaired    $_____

    ___ CCB – Richmond ($15)

    ___ NOVA – Northern Virginia ($20)

TOTAL   $_____

Please make checks payable to ACB of Maryland.  Thank you.

Please complete and return to: 

    Terry Pacheco

    Convention Registration

    1220 East West Highway, Apt. 624

    Silver Spring, MD 20910

Questions? Call 301-608-3346

Or e-mail at terrypach@aol.com


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