TACTILE GRAPHICS REQUEST FORM

Requests can take 2-3 weeks to fulfill. If you need a graphic by a deadline, please still make a request here, but also email maranda.calvin@msb.dese.mo.gov so we can get your graphics to you right away.

Question Title

* 1. NAME OF THE TACTILE GRAPHIC ie "Moon Phases"

Question Title

* 2. ADDRESS AND CONTACT INFO TO SEND YOUR GRAPHIC

Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

Question Title

* 3. NAME OF YOUR SCHOOL AND COUNTY

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* 4. Who are you?

I am blind/visually impaired/have low vision

I am a parent, guardian, or teacher of someone who is blind/visually impaired

Other (please specify)

Question Title

* 5. FILE UPLOAD Upload your file here. Most tactile graphics for the blind/VI are available through the Tactile Graphics Image Library. See Image Library

If you need an image that has not already been created or an image with additional details, please indicate that info in the next box

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Question Title

* 6. What are additional details that may you need for your graphic? Note, Outreach cannot create your graphic, we can add labels and a few extra details but will not create your graphics.

TACTILE GRAPHICS REQUEST FORM

Question Title

* 1. NAME OF THE TACTILE GRAPHIC ie "Moon Phases"

Question Title

* 2. ADDRESS AND CONTACT INFO TO SEND YOUR GRAPHIC

Question Title

* 3. NAME OF YOUR SCHOOL AND COUNTY

Question Title

* 4. Who are you?

Question Title

* 5. FILE UPLOAD Upload your file here. Most tactile graphics for the blind/VI are available through the Tactile Graphics Image Library. See Image LibraryIf you need an image that has not already been created or an image with additional details, please indicate that info in the next box

Question Title

* 6. What are additional details that may you need for your graphic? Note, Outreach cannot create your graphic, we can add labels and a few extra details but will not create your graphics.

* 5. FILE UPLOAD Upload your file here. Most tactile graphics for the blind/VI are available through the Tactile Graphics Image Library. See Image Library

If you need an image that has not already been created or an image with additional details, please indicate that info in the next box