WSSB Class Registration Formclipart of form

 

Class:             

Name:            

Address:         

City/State/Zip: 

 

Home and Work Phones: 

Email Addresses (Home and Work): 

School District:         

Your Position:          

Will you need materials in Braille or Large Print? Specify here:

 

Will you be paying by:

If Purchase Order, NUMBER:

 


           Registration fee:  $100 for Intermediate Nemeth
                                      $25 for Tactile Graphics

Make check/purchase orders payable to: WSSB and indicate class title/class date on check
            Washington State School for the Blind
            2214 E. 13th St
            Vancouver, WA 98661

      You will be receiving a response soon.  Thank You!                                                                                   


NOTE: BEFORE you press "Submit" Please print this screen for your records!