Virtual Convention Registration

National Federation of the Blind of Missouri

59th. Annual Convention - Anywhere and Everywhere on Zoom

March 26-28, 2021

Only 1 registrant per form, please submit separate forms for each registrant.

Convention *

First Name *

Last Name *

Address Line 1 *

Address Line 2

City *

State *

Zip Code *

Home Phone

(

Area code

)

Prefix

Number

Cell Phone

(

Area code

)

Prefix

Number

Email Address

What is your preferred agenda type? *

Are you a CURRENT member of the NFB of Missouri in good standing? *

Note, if you are a member of both, a chapter and a division, only select the chapter in which you are a member.

What Chapter/Division are you a member of? *

Please provide a UNIQUE phone number that you will be using to cast your votes with.

Voting Phone

(

Area code

)

Prefix

Number

Optional:

In order to assist the NFB of Missouri in its mission to help all blind people live the life that they want, I would like to make an additional

Please Note

All registrants will be contacted within 24 to 48 hours prior to the start of convention with the Zoom log-in information. For security reasons we ask that you do not share this log-in information with anyone.

Uber and Lyft Testing Program

Do you use a service animal and utilize services

such as Uber and/or Lyft? If you answered "Yes" then please help us by filling out this short questionnaire

every time you use Uber and/or

Lyft while traveling with your service animal. It does not matter if you had a wonderful experience or an experience that was not so wonderful, we want to know about every experience.

Uber/Lyft

Questionnaire

Virtual Convention Registration

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Uber and Lyft Testing Program