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WyCB Membership Application

You may download an MS Word doc of the below application here.

Name: ________________________

Street Address: ____________________________

City: __________________  State/Zip: __________________

Phone Number: ________________

Email Address: ________________________

1. Please check one:
Sighted ____   Partial ____   Blind _____

2. Please circle preferred format for "ACB Braille Forum"
Braille      Large Print      Email

3. Please circle preferred format for "Sightings"
Large Print      Email

Please make your $20 check payable to "WyCB" and remit to:

Wyoming Council of the Blind (WyCB)
Attention: Tom Smyth
123 North Lowell Street
Casper, WY 82601