AVI Parent’s Page Entry Form

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Parent’s Page Add your name to the Parent’s Page…

  • Here are some hints and tips:

  • The form is divided into two sections.
  • The first section, General Information, asks you for your name, address, phone number, etc.
  • The second section, Listed Information, requests the information you want posted on the Parent’s Page.
  • You may exclude the web page URL
  • We will not post your telephone number or your address on the page, even if you include these in the Listed Information section.
  • You may elect to use nick names, or first names to remain anonymous.
  • Please contact AVI (see below) if you are interested in including a small picture of your child or your family in your listing (JPEG or GIF format).
  • Often, pressing “return” on your keyboard will submit the form. If you should accidentally submit the form before you are finished completing it, just press the “back” button on your browser and resubmit the form. The last entry sent will be posted.
  • Please contact the AVI (see below) if you have questions.

Please contact us at [email protected] for additional information.

General Information
This information will not appear on thelisting, and is for AVI use only.

1. Your name   
2. Address   
3. City   
4. State   
5. Zip   
6. Country
7. Phone
8. E-mail address
9. Are you currently an AVI Member?
Yes
No
10. Other information Select all that apply
Adult Who is Hearing Impaired
Parent or Guardian of a Child Who is Hearing Impaired
Grandparent of a Child Who is Hearing Impaired
Other (please specify)
11. Comments

Listed Information
Next, enter the information you want listed on the Parent’s Page.

12. Please List: Parent’s or guardian’s names   

13. Please List: Children’s Names Age   

14. Please List: E-mail address   

15. Please List: Web Page URL   

16. Please List: City/State/Country   

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