Supporting Blind & PS Students in HE/FE 
REGISTRATION OF INTEREST FORM

Please complete the following details, and return your signed form to the address below. 

Title (e.g. Miss, Mrs, Mr, Dr): 

First Name: 
Surname: 

Job Title: 

Mailing Address: 


Tel: 
Fax: 

E-mail: 


Please inform me of the details of future courses.


Please specify any special dietary requirements you have:


Please specify any other special requirements you have (e.g. if you 
require course materials in an alternative format)


Signed: 

Date: 

Return Form To: 
Short Course Administrator, 
RNIB National Centre for Tactile Diagrams, 
58-72 John Bright street,
Birmingham, B1 1BN
Tel: 01707 286 348
Fax: 01707 285 059