Registration due January 6, 2023

Question Title

* 1. Contestant's Last Name:

Question Title

* 2. Contestant's First Name:

Question Title

* 3. Parent Contact info:

Question Title

* 4. Gender:

Question Title

* 5. Birthdate:

Date

Question Title

* 7. Has participant ever used a refreshable braille display?

Question Title

* 8. Does participant have regular access to a refreshable braille display or notetaker?

Question Title

* 9. Has participant ever paired a refreshable braille display or notetaker to an iPad, iPhone, or Android device?

Question Title

* 11. Name of Teacher of the Visually Impaired:

Question Title

* 12. Teacher's Email:

Question Title

* 13. Teacher's Phone:

Question Title

* 14. Participant Contest Level:
Note: All contests are in UEB format only.

Question Title

* 15. Participant is competing:

Question Title

* 16. Does the participant require any additional accommodations other than braille (interpreter, food restrictions, etc.)?

Click "done" below to submit student registration, and then please continue to fill out the permission form. If you are an educator filling this form out for a student, you should forward the link to a parent or guardian to complete. If the student is a self-guardian, they may complete the form themselves.

Link to Permission Form: https://www.surveymonkey.com/r/STLRBC2023Permission 


PLEASE NOTE: Registration is not complete until permission form is received.

T