Friends in Touch - Participant Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please complete the information about yourself to participate in the letter exchange program.

Email *

My Name *

The language or languages I would like to communicate in: *

The Country I live in *

My age *

My Interests

My Email Address *

I am interested in receiving/sending physical mail

Yes

Clear selection

I would like to be contacted for help with accessibility

Yes

Clear selection

How I want to receive and read mail - please check all that apply and use other to describe further requests (such as large print, contrast, video captioning, and image description)

text based emails

photograph based emails

picture symbol based emails

videos

audio clips

text based physical mail

Braille based physical mail

photographs by physical mail

tactile physical mail (such as puff paint, textured collage, object writing)

Other:

How I want to send and write mail - please check all that apply and use other to describe further requests (such as large print, contrast, video captioning, and image description)

text based emails

photograph based emails

picture symbol based emails

videos

audio clips

text based physical mail

Braille based physical mail

photographs by physical mail

tactile physical mail (such as puff paint, textured collage, object writing)

Other:

I give consent for the Deafblind International Youth Network to share my email address with another participant in the Friends in Touch program. *

Yes

I give consent for the Deafblind International Youth Network to share my feedback on the program. *

Yes, including my name and age.

Yes, but anonymous.

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms