The American Printing House for the Blind (APH) regularly conducts beta 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 future beta test opportunities, please complete and submit this form.

NOTE : The questions on this form are in reference to the individual completing the form.

Beta Tester Classification (check all that apply):

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

Primary Contact Information

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* 2. Primary Contact Information

Do you work with students/clients who are blind or visually impaired?

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* 3. Do you work with students/clients who are blind or visually impaired?

Your visual function:

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* 4. Your visual function:

Your ethnicity/race:

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* 5. Your ethnicity/race:

Your age range:

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* 6. Your age range:

Have you conducted beta/field testing for APH in the past?

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* 7. Have you conducted beta/field testing for APH in the past?

What product(s) are you currently interested in testing? 

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* 8. What product(s) are you currently interested in testing? 

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