Membership Form

First Name (required)

Last Name (required)

Date of Birth (required)

Marriage status (required)

Occupation(required)

Education (required)

Visual status (required): sightedpartially sightedblind

Phone/Addresses

Street and House number (required)

city (required)

State/Province (required)

Postal/Zip Code (required)

Country (required)

WhatsApp/Phone Number (required)

Email (required)

Skype ID

I agree that my data may be stored byAssociation of Iranian and originally Iranian blind and visually impaired people,ViBSe.V, This data may not be passed on to third parties unless I agree explicitly, with the exception of the Germany’S Federal Data Protection Act and other similar European Laws.

Important: The member must inform the Association immediately when his/her information stated above changes!