Vision-Aid Live Training Program Registration
Registration
Email *
Please type your Name *
Your Mobile Number *
Your Gender *
Please type your Age *
Which City & State are you from? *
Select The Course *
Required
What is your long term learning Objectives?
Please provide a brief history of your vision impairment *
What is your usable vision in terms of acuity and field?
What is the percentage of vision loss?
How did you hear about this program ? *
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