ACB Next Generation Membership Application
Dear Incoming Member:
Thank you for your interest in becoming a member of ACB Next Generation. We are excited to have you and eager to learn more about you. Becoming a member is easy. There are two important steps. First you will need to complete our Membership Application Form. The second step is to pay your ACB Next Generation dues of $15.
 Those instructions will be on the confirmation page. Please note that failure to complete both of these steps will result in an incomplete application and that we cannot accept members under the age of 18 at this time. *Members who pay during the ACB National Conference and Convention from June 22-July 13, 2022 will be paid through 12/31/2023.  Members who pay on or after September 1 of the current year will be paid to the end of the following calendar year. Dues are non-refundable except in the case of an overpayment.
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First Name *
Middle Name *
Last Name *
Street Address *
City *
State *
Zipcode *
Phone Number (Please indecate cell or home). *
E-mail Address *
Birthday *
MM
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DD
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YYYY
I am Joining as a *
Are you an ACB Life Member? *
What is your visual status? *
Are you a member of your local state affiliate? *
In which format would you like to receive the braille forum? *
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