2026 PCB Conference and Convention Registration Form 2026 PCB Conference and Convention Registration Form Growing Independent, TogetherOctober 22-25, 2026Registration is FREE!! Invite a friend!! Name*FirstLast Address* Street Address Street Address Line 2 City State Zip Code Email Phone*Preferred format of your Conference Program:(Note: If your registration is received after October 5th, your program book will only be available electronically, either in Word via email or in Daisy audio download from our website.) Select One:*BrailleAudio/Thumb DriveLarge PrintEmailConnecting to the Conference: When using a land line phone, Zoom is a toll call unless you have an unlimited long-distance calling plan. Do you have an unlimited long distance calling plan?YesNo Do you need the toll-free number to call into the conference?YesNo Referred by a friend: Were you encourage to attend the conference by a PCB member?YesNo If someone did refer you, please name the person so we can enter them to win a prize.Conference Activities: Please indicate how you would like to participate. Descriptions of each event are enclosed on the preliminary schedule.Saturday, October 24, 20261:00 PM PCB Business MeetingOnly paid 2026 PCB members who are registered for the conference may attend this event. All who expect to vote should be sure to join the meeting as an individual to retain their individual PCB vote. Since we will use Zoom's hand-raising function, married couples, those using three-way calling, and other who typically share a connection should plan for accessing through their own devices. Will you need toll-free calling service to access the business meeting?YesNoSunday, October 25, 20263:00 PM PCB Live AuctionToll-free calling service is not being offered for this fundraiser event. We will do our best to match those without Zoom access with a peer phone partner who does have access. Please indicate your situation for the auction.I will attend.I do not have unlimited long distance calling and would need to be brought into the auction.I am willing and able to bring someone else into the auction by phone.I will not attend. Optional Demographic Information: Please check all that apply to you.I have a vision-related disability.I have a hearing-related disability.I have a physical disability.I have a learning-related disability.I do not have a disability.I am a first-time attendee to the conference.Would you like to purchase any 50/50 tickets to support our Room Rate Fund to subsidize the overnight rate for our next in-person conference? Tickets are $5.00 each. Please type the dollar amount into the box below. (Ex: Type $5.00 for one ticket; $10.00 for two tickets, etc.) USD General Conference Support: Please consider contributing to support this year's conference. Anyone who donates at least $5.00 can give a community shout-out in the conference program.Select productPatron ($5.00)Contributor ($10.00)Benefactor ($25.00)I would like to contribute a different amount. If donating a different amount, please enter it here. USD Total Complimentary Community Shout-Out: If you are contributing at least $5 in support of the conference, please include an upbeat shout-out to be published in the conference program. Must be 15 words or less. (Sample: Congratulations! Joe and Jill Blink celebrating 25 years together. We love you J&J! - Their Chapter) Your Shout-Out:PCB has instituted a prohibited conduct policy for all meetings and events. By submitting this form, you are agreeing to abide by this policy.If you do not wish to pay online, please click submit, then exit your browser and call the PCB Office at 877-617-7407 ext. 800. If you are paying online, please click submit and proceed through the PayPal system. You DO NOT need to have a PayPal account to use the PayPal system.SubmitReset
