New Listing Form

Companies Specializing In
Products For The Blind

Use this form to submit information about your company for possible inclusion in our list of Companies Specializing In Products For The Blind. Items marked with an (*) are required; your company will NOT be listed if any of the required information is not provided. The rest of the items are recommended but optional.

Please provide your name and E-Mail address so we can contact you if needed. If you'd like you can choose a password which you will then be required to use any time you update your company's listing. The password is an extra precaution but is not a guarantee of security.

If your browser can't handle forms click here for a text form you can E-Mail to newcompanylisting@blind.net.

Do you work for this company?	*	Yes - I work for this company. No - I don't work for this company.
Contact's Name:	*
Contact's E-Mail:	*
Password:
Company Web Site URL:
Company Name:	*
Suite #:
Company Street Address:	*
P. O. Box:
City:	*
State:	*
Zip Code:	*
Country:	*
Voice - Phone:	*
TDD - Phone:
TOLL FREE - Phone:
FAX - Phone:

E-Mail You can list upto 5 E-Mail addresses. You can also provide a description or person's name for each of the 5 E-Mail addresses.
	Name or description	-	name@company.com
E-Mail 1:		-
E-Mail 2:		-
E-Mail 3:		-
E-Mail 4:		-
E-Mail 5:		-

Company Description

Your company description must meet the following requirements and may be edited for length and/or clarity.

Be no more than 75 words. The text area is set to show 420 characters which is about 75 words; so if the text starts scrolling you've written to much.
Should only describe the products available and avoid hyperbole. (Like the plague ... or was that cliches. :) )

Company Publications

List the publication(s) produced by your company; catalogues, brochures, magazines, newspapers, etc. Include the name and how often each is published. Please put one publication per line or separate multiple items with a blank line. This list is not intended for listing articles published by individuals or companies in journals, magazines, newspapers or other periodicals.

Type of products sold

Choose all that apply.
Braille - Braillers, slate, stylus, printers, Braille paper.
Electronics - Recorders, radios, TVs, telephones.
Games - cards, board games, computer games.
Home - Sewing, cleaning.
Kitchen - Measuring devices, guides, timers.
Magnifiers - Closed circuit TV, lenses, screen magnifying programs.
Medical - scales, thermometers, diabetes related, blood pressure.
OCR - systems, scanners, programs.
Screen readers - speech output, Braille output.
Time - watches, clocks.
White canes - canes, tips, other mobility items.
Other - please specify.

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