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C-Print Service Providers Membership Form

This registration form is C-Print captionists and captionists in training who would like to become members of the C-Print Service Providers Organization. You will receive your username and password in approximately 10 days.

Membership Registration for C-Print Captionists

* Indicates Required Fields
* Name

Enter the address you would like to prefer to be contacted at: * Home Work
* Street Address

* City

* State

* Zip

* Telephone (daytime)

Telephone (alternate)

Fax

* Email

* What year were you trained?

* Who was your trainer?

Organization /
School / Agency

Additional Information

Which best describes your c-Print captioning activity at present?

Active
Inactive
In Training

What is your expected completion date for training?


What type of computer are you currently using?
Operating system, hardware information, wireless capability, other...

In what settings do you currently provide C-Print services?

This information is being gathered to establish a national directory of C-Print captionists.
A list captionists and their contact information will be available to all registered members.
If there is specific information you do not want available to other members please specify below.

A modified list will be available to the public including name, city, state, email address, and phone number.
This list is made available to those wishing to hire a C-Print captionist.

Yes, I wish to be included in this public list.
No, I do not wish to be included in this public list.

If you choose to be listed, is there specific information that you do not want included?

Do you have other questions or comments?