Early Childhood Application

The early childhood initiatives of the National Federation of the Blind provide young blind children and their families with support and guidance to master the fundamental skills of literacy and independent travel. Please complete this form to sign up for one or more of our early childhood programs.

Note: All fields with an asterisk (*) are required.

I wish to sign up for the following NFB Early Childhood Initiative programs: *
Parent/Guardian Information

Parent/Guardian Information

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Participating Child's Information

Participating Child's Information

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Birth Date:*
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Other Information

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The National Federation of the Blind pursues grant funding to support our programs, and some of these grantors ask us to describe the backgrounds of participants in our programs. In order to improve our program delivery and to respond to these requests, we ask you to answer the following questions:

Please select the racial category or categories with which this child most closely identifies by selecting the appropriate box. *
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Please select the “Submit” button to complete your NFB Early Childhood Initiative application. Please allow up to four weeks to receive your materials.