Designation Form for Ex Officio Trustees of the American Printing House for the Blind, Inc.

This document designates an Ex Officio Trustee of the American Printing House for the Blind for the purposes of administering the Act to Promote the Education of the Blind. This designation will remain in effect until further written notice is presented to the American Printing House for the Blind.

Name of School, Educational Program, Agency, or State Department of Education and account number(s):

Name of New Ex Officio Trustee:

Signature of New Ex Officio Trustee: __________________________________________

Title:

Mailing Address:


Phone:     Fax:

E-Mail Address:

Reading Material Preference:
Print    Large Print    Braille    CD Flashdrive

Name and Title of Appointing Officer:

Signature of Appointing Officer: _____________________________________

Address:

Phone:     Fax:

E-Mail:

Date:

• The Ex Officio Trustee is the head of a state department of education, residential school for the blind, or other agency serving the blind, or their designee and must be designated by the head of each respective organization, as follows: head of the state department of education, superintendent of a residential school for the blind, or the executive officer of other agencies serving the blind.
• Please fax a copy of the completed form to Cindy Amback at (502) 899-2363 and keep a copy for your agency’s records. Then snail mail the signed, original, hard copy of the document to: American Printing House for the Blind, Attn: Cindy Amback, 1839 Frankfort Avenue, Louisville, KY, 40206. Questions should be directed to Cindy at (800) 223-1839, extension 257. Designation becomes final upon receipt of the original, signed, hard copy.

Featured Content

Accessible
Textbooks

Custom Media
Solutions

Museum

Hall of Fame

• Customer Care
• Contact Us
• Ayuda a Nuestros Clientes en Español
• Press Room
• Privacy Policy
• Legal Terms & Conditions

© Copyright American Printing House for the Blind, 1839 Frankfort Ave, Louisville, KY 40206 (Directions).
From U.S. and Canada call toll-free 1-800-223-1839. Open weekdays 8 a.m.–4:30 p.m. (EST).

APH is a 501(c)(3) nonprofit organization.