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NFB Link - Mentor Application

Your Name:

Name Prefix *
First Name *
Last Name *
Middle Initial

Contact Info:

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Address Line 2 *
City *
State *
Zip *
Email Address *
Password *
Confirm Password *
Telephone number *
Alt. Telephone number

General Information:

Date of Birth (Day) * Date of Birth (Month) * Date of Birth (Year) *
Select Occupation *
Gender *
I am blind or visually impaired: * Yes No
Indicate highest degree earned: *
Ethnicity:
List languages spoken other than English

Membership:

What chapter do you belong to
State affiliate

Leadership:

Check any of the leadership positions you have held: Local Chapter OfficerState Affiliate OfficerNational OfficerCommittee/Division Chair

Mentoring Details:

Maximum number of people you would like to mentor at once *
Areas of expertise you would feel comfortable mentoring others in:
Accountants Architects Agriculturalists Automobile Mechanics Braillewriter Machinists Carpenters Chefs Child Care Professionals Computer Scientists Communication Professionals Culinary Professionals Customer Services Representatives Entrepreneurs Engineers Equestrians Finance Professionals Health Care Professionals Heating & Cooling Contractors Homemakers Human Service Professionals Journalists Legal Professionals Marketing Professionals Massage Therapists Music Technicians Musicians/Composers Nutritionists Orientation & Mobility Professionals Pet & Animal Service Professionals Plumbing Contractors Real Estate Agents Scientists Theologians Travel Agents Real Estate Agents Veterinarians Writers/Authors Woodworkers
Administration
Blindness Programs Specialists Executive & Managerial Professionals General Office Workers Public Employees
Artists
Artisans (crafts-people) Performance Artists Visual Artists
Rehabilitation Professionals
Administrators Counselors Teachers Trainers

Topics you would like to provide information on: Applying for College Assistive Technology Band Braille Choir Cleaning Cooking Doing Laundry Exercising Gardening Grocery shopping Home repairs Indoor and Outdoor Sports Knitting Operating a Telephone Personal Grooming Recording Devices Sewing Transportation methods Using Readers Woodworkers

Services you could provide information on: Library Services Newsline® Randolph-Sheppard Program Recordings for the Blind and Dyslexic Rehabilitation Issues Scholarships Special Education Social Security
People you would like to mentor: Students Senior Citizens Diabetics Guide Dog Users Individuals Seeking Career Advice Parents of Blind/visually impaired Children Parents Who Are Blind/visually impaired Veterans Multiply Disabled Deaf-Blind individuals Sighted Professionals (ophthalmologists etc.) Other
Please list any other interests or hobbies for which you would like to provide mentoring:

Submit:

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I have read and agree to the terms of the NFB Link member agreement. Yes

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