Louisiana Council of the Blind
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BOARD of DIRECTORS
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LET'S BINGO!!!
OUR MISSION
BOARD of DIRECTORS
STATE CHAPTERS
RESOURCES
DONATIONS
CONTACT
LET'S BINGO!!!
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LCB MEMBERSHIP APPLICATION
You are applying for application to LCB.
Upon acceptation, you will also be entitled to membership of the ACB,
(American Council of the Blind.)
*
Indicates required field
Name
*
First
Last
CELL PHONE
*
HOME PHONE
*
WORK NUMBER
*
FAX NUMBER
*
Email
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
I AM:
*
TOTALLY BLIND
VISUALLY IMPAIRED
SIGHTED
FORMAT (LCB MATERIAL)
*
BRAILLE
LARGE PRINT
EMAIL
BRAILLE FORUM
*
BRAILLE
LARGE PRINT
CASSETTE
EMAIL
I hereby certify the above information is true and I wish to become a member of the Louisiana Council of the Blind.
By signing my name below, I commit to membership of LCB.
SIGNATURE
*
DATE
*
BIRTHDAY (Month/Day) Year Optional
*
Dues for membership to LCB are $10 each year. These dues entitle a member to automatic membership within ACB, the American Council of the Blind.
In effort to lower cost and keep our funds , an email will be sent to you ahead of time to remind you of your fees.
Thank you,
LCB State Officers
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OUR MISSION
BOARD of DIRECTORS
STATE CHAPTERS
RESOURCES
DONATIONS
CONTACT
LET'S BINGO!!!