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American Council of the Blind
CREATE AN ONLINE ACCOUNT WITH ACB
Create your ACB online account by registering on this form. For increased online security, create a username and password below that you don't use anywhere else.
First Name
Middle Name
Last Name
Username
Password
Confirm Password
Email
Mobile Phone
Home Phone
Address
City
State/Province
select State or Province
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
Washington, DC
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland/Labrador
Nova Scotia
Ontario
Prince Edward Island
Quebec
Saskatchewan
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
none
Zipcode or Postal Code
Gender
select Gender
Female
I identify as a Female
Male
I identify as a Male
Nonbinary
Other
Prefer not to answer
Ethnicity
select Ethnicity
Asian
Black or African American
Hispanic or Latino
I prefer not to answer
Middle Eastern or North African
Multiracial or Multiethnic
Native American or Alaska Native
Native Hawaiian or other Pacific Islander
Other
South Asian
White - Anglo-Caucasian
Vision Status
select vision status
I identify as Blind
I identify as Visually Impaired
I identify as Sighted
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