WCB Membership Change Form If you are human, leave this field blank.UPDATE MEMBER INFOFirst Name *Middle NameLast Name *Preferred NameAddressCityStateZipPrimary Phone Number *Primary Phone Type *Select OneMobileHomeAlternative Phone NumberAlternative Phone TypeSelect OneHomeMobileEmailACB REQUIRED DATAOver the age of 18?Please select oneYesNoVisual StatusPlease select oneIdentify as blindIdentify as visually impairedIdentify as sightedIf visually impaired, are you legally blind? Please select oneYes, legally blind No, not legally blind Lifetime Member of ACB? Please select oneNoYesACB Braille Forum PreferencePlease select oneBraille digital cartridge email 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 onedigital cartridge email large print noneOPTIONAL 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 $1 to offset the PayPal fees charged to WCBJoin WCB as a Member at Large (no local chapter or affiliate) Join local chapter(s)/special interest affiliate(s) below. PLEASE NOTE: some groups may have additional requirements before your local membership will be effective. Special Interest Affiliates (statewide)Guide Dog Users $15 GDUWSWCB Diabetics $5 WCBDLocal ChaptersCapital City Council of the Blind $5 CCCBClark County Council of the Blind $10 CLCCBJefferson County Council of the Blind $4 JCCBPeninsula 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 YVCBComments PLEASE BE SPECIFICSubmit
