Future Reflections                                                                                       Convention, 2002

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NOPBC 2003 Activities Preregistration

Mail to:

Sandy Taboada
NOPBC Preregistration
6920 South Fieldgate Court
Baton Rouge, Louisiana 70808-5455
E-mail: smerchant@mail.vetmed.lsu.ed

Fees: $10, one adult, no children; $15 one adult, children; $25, two adults, children

Adult Name(s). Please include first and last name of each adult and indicate if the adult is a parent, grandparent, blind parent, teacher, other relative, etc.

1._______________________________________

2._______________________________________

Address__________________________________

City, State, ZIP____________________________

Telephone (     )____________________________

E-mail ___________________________________

Fee enclosed (make checks payable to NOPBC)  $___________

REMEMBER TO DEDUCT $5 FOR  EARLY REGISTRATION.

Will you be bringing children? [ ] Yes   [ ] No   [ ] Undecided

If yes or undecided, please list names and birth dates of child(ren); reading mode (Braille, print, large print, non-reader); and brief description of characteristics of which workshop volunteers should be aware. Examples: Mild autism; wears hearing aid; has ADHD; shy— doesn’t talk to strangers.

Finally, check the workshops your child may be interested in attending. Please note the age restrictions. The lower limit on the Braille Carnival is firm. The age limits on the other workshops may go up or down by a year or two depending on circumstances. Youngsters over eighteen who are still in high school may also participate in the appropriate workshops. Please copy this form or add a sheet of paper if you need space to register more children.

CHILDREN

1. Name & birth date_______________________________________

Reading mode____________________________________________

Characteristics____________________________________________

Please preregister my child for:

__Braille Carnival (4-up)                                           10:00 – 12:30 p.m.

__Note Taking (blind, 14-18)                                    10:30 – 12:00 p.m.

__Baby-sitting Clinic (12-18)                                     11:30/12:00 – 4:30 p.m. (includes lunch)

__I Want to be a Writer (13-16)                                 2:00 p.m. – 4:00 p.m.

__Braille Is Beautiful (8-11)                                      2:00 p.m. – 4:30 p.m.

__Exploring Careers in Blindness (16-18)                   2:00 p.m. – 4:00 p.m.

__Teen Discussion Groups (blind, 13-18)                   8:00 p.m. – 9:30 p.m.

__Touch the Universe                                                Times to be announced

2. Name & birth date_____________________________ ______________

Reading mode________________________________________________

Characteristics________________________________________________

Please preregister my child for:

__Braille Carnival (4-up)                                             10:00 – 12:30 p.m.

__Note Taking (blind, 14-18)                                      10:30 – 12:00 p.m.

__Baby-sitting Clinic (12-18)                                       11:30/12:00 – 4:30 p.m. (includes lunch)

__I Want to be a Writer (13-16)                                   2:00 p.m. – 4:00 p.m.

__Braille Is Beautiful (8-11)                                       2:00 p.m. – 4:30 p.m.

__Exploring Careers in Blindness (16-18)                     2:00 p.m. – 4:00 p.m.

__Teen Discussion Groups (blind, 13-18)                    8:00 p.m. – 9:30 p.m.

__Touch the Universe (9/up)                                       Times to be announced

Please copy this form or add a sheet of paper if you need to register more children
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