LEGO Braille Bricks Kit Request Form

Please complete this form to request free LEGO Braille Bricks Kits. Note that we have a small number of Spanish kits available, and you can specify your language preference in the form. Shipping method will be Free Matter for the Blind. Please review and agree to the terms of use at the bottom of this page before placing your order.

Name*
First Last
Organization Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Trustee Account Number*
Phone*
Email*
Please specify if you are requesting English or Spanish kits*
- English
- Spanish
Requested Number of Kits*
Number of LEGO Braille Bricks kits requested (Note that kits will arrive in multiples of four (4). We will round up you request as needed in order to meet our shipping requirements)
Please enter a number greater than or equal to 1.
LEGO Braille Bricks Terms of Use*
I understand and agree to the LEGO Braille Bricks Terms of Use:*
LEGO Braille Bricks are to stay in the possession of the defined “User Group”, meaning private or public schools, institutes, education centers, etc. in the Territory where one or more blind or visually impaired children receive education and support, including in respect of the Braille system, as well as professional individuals associated with or operating at such schools, institutions, education centers, etc. in connection with such education and support to blind and/or visually impaired children.

"User Group" does not comprise any other private or public legal entities, institutions, organizations, etc. or other individuals, such as parents of blind or visually impaired children, or blind or visually impaired children themselves.

LEGO Braille Bricks will be delivered to the member of the User Group exclusively for its own use in the education and support to blind and/or visually impaired children and that the member is not entitled to sell, lend out or give away any LEGO Braille Bricks to anyone not part of the User Group.

LEGO Braille Bricks are to be used by children ages four (4) and up. Due to choking hazards this product is not to be used with children younger than three (3) years.
User Group Consent*
I acknowledge that I am a member of the User Group*
Email
This field is for validation purposes and should be left unchanged.

If you need assistance or have any questions please contact us directly: 1-800-223-1839 or email us cs@aph.org