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Free Slate and Stylus Program

Thank you for your interest in the Free Slate and Stylus Program. You will receive an aluminum 4-line, 28 cell slate with the Whozit logo and an apple green plastic stylus. Please fill out the required information below. For questions regarding the Free Slate and Stylus Program email us at [email protected].

*Required field(s) are indicated by an .**
* First Name:
* Last Name:
* Address:
Address 2:
* City:
* State:	* Zip Code:
* Phone:
* Birth Date:	* Birth Month: * Birth Day: * Birth Year:
* Email:
* Verify Email:
* Member of NFB?
* Braille Reader?
Acknowledgement
By requesting this slate and stylus I acknowledge that: It is more than one year since a previous request for a slate and stylus. I am blind or visually impaired, and this slate and stylus is for my personal use; OR I am making this request on behalf of a child under the age of eighteen who is blind or visually impaired, and the slate and stylus is for his/her personal use. By selecting the checkbox below marked "I Accept", you acknowledge that you have reviewed and agree to all of the statements above. * I Accept

Free Slate and Stylus Program

Acknowledgement