skip to content
 
Registration: Annual ICB Membership (1 year) (01-31-2010 - 01-01-2011)

Your total Registration cost: $ 10.00
USER INFORMATION
( * = required field )
First Name:  *  
Last Name:  *  
Organization:
Address:   *  
City:   *  
State:   *  
Zip Code:   *  
Email:  *  
Confirm Email:  *  
Phone:    *  

ADDITIONAL INFORMATION
Do you want the Illinois Braille Messenger in 2011?:
What is your level of vision?:
Preferred format for correspondence:
 
Illinois Council of the Blind | P.O. Box 1336 | Springfield, Illinois 62705-1336 | 217.523.4967, 866.850.1336 | icb@icbonline.org
Illinois Council of the Blind. All rights reserved.