WCB Membership Change Form If you are human, leave this field blank.UPDATE MEMBER INFO If you don't need to update data, but want to pay dues, please complete only the 3 required fields: first name, last name, mobile phone number. This will reduce the need to compare database info field-by-field to determine what should be updated. Thank you!First Name *Middle NameLast Name *Preferred NameAddressCityStateZipMobile Phone Number *Home Phone NumberEmailACB REQUIRED DATAOver the age of 18?Please select oneYesNoVisual StatusPlease select oneIdentify as blindIdentify as visually impairedIdentify as sightedLegally blind? Please select oneYes, legally blind No, not legally blind Lifetime Member of ACB? Please select oneNoYesACB Braille Forum PreferencePlease select oneemail Braille digital cartridge large print noneACB mail preferencePlease select oneBraille large printnoneGenderPlease select onefemalemaleI identify as femaleI identify as malenonbinaryotherdecline to answerEthnicityPlease select oneAsianBlack or African AmericanHispanic or LatinoMiddle Eastern or North AfricanMultiracial or MultiethnicNative American or Alaska NativeNative Hawaiian or Pacific IslanderSouth AsianWhite - Anglo/Caucasianotherdecline to answerWCB Newsline PreferencePlease select oneemail digital cartridge large print noneShare info within WCB?Please select oneYesNoOPTIONAL Dues PaymentPlease select oneAnnual WCB member $10Annual WCB junior member (under 18) $6Annual ACB member (WCB Life member) $5Annual WCB member (ACB Life member) $5Life WCB member $150Donate $2 to offset the PayPal fees charged to WCBJoin WCB as a Member at Large (no local chapter or affiliate) Join one or more local chapters or state-wide special interest affiliates by paying annual dues for the calendar year (January to December). Special Interest Affiliates (statewide)Guide Dog Users $15 GDUWSWCB Diabetics $5 WCBDWCB Next Gen $5 WCBNGLocal ChaptersCapital City Council of the Blind $5 CCCBClark County Council of the Blind $10 CLCCBPeninsula Council of the Blind $5 PCBPierce County Association of the Blind $5 PCABUnited Blind of Seattle $5 UBSSkagit & Islands Counties Council of the Blind $10 SICCBSnohomish County Council of the Blind $5 SCCBSouth King Council of the Blind $5 SKBSouth Kitsap Council of the Blind $5 SKCBSpokane Council of the Blind $5 SCBUnited Blind of Tri-Cities $2 UBTCUnited Blind of Walla Walla $5 UBWWUnited Blind of Whatcom County $5 UBWCYakima Valley Council of the Blind $5 YVCBCommentsIf you've paid dues for multiple chapters, please indicate your choice for "home chapter." Your home chapter is responsible for remitting your WCB/ACB dues and info updates in the future. If you are submitting this form on behalf of a new member in your chapter in order (to remit dues electronically or to submit data without delay), you must indicate the effective "join date" when dues were paid locally.Submit
