Membership

Secure Membership Form

Please consider a voluntary $10 membership in the Canadian Council of the Blind by completing the membership form below. CCB is Canada’s largest consumer group for blind and vision impaired people. In order to do our important advocacy work to government, business, and other organizations on behalf of this vision impaired community it is  important to demonstrate a large stable membership list. Please join us as a new or renewed member to lend your name as Canada’s voice of the blind.

Name *

Last Name *

Email *

Phone *

Address *

Address Line 1

Address Line 2

Address Line 2

City *

City

Province *Select a ProvinceAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanNorthwest TerritoriesNunavutYukon

Province

Postal Code *

Postal Code

Country *

Country

Chapter *

• Independent member – No Chapter
• CCB Chapter

Chapter Name *

Enter the name of the chapter

Membership Type *

• First Time Member – $ 10.00
• Renew Membership – $ 10.00
• Volunteer – $ 0.00

Total Amount

$ 0.00

Date of Birth

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Optional (Year only OR Year Month OR Full Date of Birth)

Category *

• Blind
• Visually Impaired
• Sighted

Language Preference *

• English
• French

Comment or Message

Payment Information

CCB does not retain any credit card information.

Payment Method *

• PayPal
• Credit Card Payment

Credit Card *

Card

Name on Card

Submit

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