First and Last Name:     Last Name:(Necessary for all transactions)

Company Name:

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Former Name and/or Mailing Address:

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We try to plan the conference workshops around the professions of our members. Please indicate your primary area of interest:

Please Select Transcriber Educator Dual Credential O&M Parent Proofreader Vendor
Other (Please briefly describe)

The CTEBVI JOURNAL is printed quarterly. Please select format:
Print Braille Audio CD Virtual (email address required) Floppy disk .doc formt
**Conference 2011 registration packet will be available on this Web site only

Thank you in advance for your a donation. Please choose from the following funds:
General Fund Donna Coffee Scholarship Katie Sibert Scholarship

Click below to send report to Membership Chair and continue on to payment page for both membership and donations.