Listing Form

Use this form to submit information about your company or organization for possible inclusion in our list of Companies and Organizations. 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 need 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 this form click here for a text form you can E-Mail to newlisting@blind.net.

Do you work for this company?	*	Yes - I work for this company. No - I don't work for this company.
Contact Name:	*
Contact E-Mail:	*
Password:
Company Web Site URL:
Company Name:	*
Company Street Address 1:	*
Company Street Address 2:
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@organization.com
E-Mail address 1:		-
E-Mail address 2:		-
E-Mail address 3:		-
E-Mail address 4:		-
E-Mail address 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 services provided

Choose all that apply.
Rehabilitation Center - teaching mobility, living and other skills.
Residential School - complete education courses.
Guide Dog School - Training guide dog teams.
Other - please specify.

Comments

Back to the Blind Net home page.

Send your questions or comments .