2023-2024 ACB Students 
Hello students! We are thrilled that you are interested in joining our vibrant and growing community of blind/low-vision students across the country! Please fill out this form so that we can register you as a member in the affiliate! If you have any questions, comments, or concerns please do not hesitate to leave them below and you will receive a response via email as soon as possible. Again, we are excited to have you join and believe that you will find great benefits as a member.  
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Email *
Phone number *
First name, Last name  *
Date of Birth  *
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Name of College / University / School  *
Year/Grade in College. Check other if high school  *
To support the affiliate, we levy nominal dues to our membership. 

Select how you would like to pay your dues: 
Title the payment "ACB Students Scholar"
 *
Please select "Yes", stating your intention to pay within 24 hours of submitting this form. If you are unable to pay dues to financial hardship or extenuating circumstance, please select no (We will contact you with more information in this case) *
Do you have questions, comments, or concerns? 

We are so excited to have you join and look forward to meeting you!
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