Braille Reading Pals Club Registration Form

After filling out the required fields, please select the submit at the bottom of the page.  If you are registering more than one blind child, please start a new registration form for each child.  Please be sure to use a valid e-mail address before submitting your registration form.

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Your Contact Information

Participating Child's Information

Optional Background Information: Please answer the following questions to the best of your ability. Your feedback is the only way for us to make our program better. When you submit the registration form, your child will be included in the program.

Other Information

Future Reflections is a magazine for parents and teachers of blind children. It is published quarterly by the American Action Fund for Blind Children and Adults in partnership with the National Organization of Parents of Blind Children.
I wish to register for the 2011 Braille Reading Pals Club. I understand this is an early Braille literacy program for blind and low vision pre-readers (babies, toddlers, preschoolers, and young children who are not yet independent readers). This program is for children ages seven or younger, and the child/children that I am registering are currently within this age range. Participants in this program must be under the age of eight by the beginning of the program year, which is January 1, 2011. This program is only open to participants in the United States and Canada.