The American Printing House for the Blind (APH) regularly conducts field tests of new products that are under development. APH uses the comments and recommendations gathered from experts in the field to refine and improve products before actual production. If you would like to be considered for field test opportunities during the 2022-2023 school year, please complete and submit this form.

NOTE : The questions on this form are in reference to the individual (e.g., TVI) completing the form.

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* 1. Field Tester Classification (check all that apply):

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* 2. Contact Information 
Please provide the address at which you would like to receive testing materials. For professionals in the field only, the job title/description and school/agency fields are required.

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* 3. Your areas of interest/expertise (check all that apply):

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* 4. Please list any professional certifications and degrees you may have. Use N/A if not applicable.

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* 5. How long have you been a TVI/adult consumer of APH products/parent of a child with visual impairment?

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* 6. Which categories of students or clients/consumers do you work with? Check all that apply.

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* 7. In a typical year, what is your caseload?

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* 8. Your visual function:

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* 9. Your preferred reading medium:

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* 10. Are you available for field-testing activities during the months of June, July, and/or August?

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* 11. How did you first hear about APH?

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* 12. Do you have a contact at APH?

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* 13. Have you conducted field testing for APH in the past?

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* 14. Is there a particular product that you would like to test or feel especially qualified to test? Please explain why.

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* 15. What is your age?

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* 16. What is your ethnic background? Please check all that apply.

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