Test page - American Council of the Blind of Virginia

Technical Support Request

Complete if Technical Support is selected in Queston 17.

What type of technical support do you need? (required) *Choose what type of technical support you need. Multiple selections allowed.Device SetupTroubleshootingSoftware InstallationSoftware UpdatesSoftware UpgradesAccessibility ConfigurationAssistance with Mainstream Technical SupportOther. Describe in next question.

Please briefly describe the technical support you need. (required) *

Please describe the specific technical issue or support need. (required) *

American Council of the Blind of Virginia

Customer Information

All information submitted will be kept confidential and used solely for ACBVA planning purposes.

Eligibility & Verification

Financial Need

Request Type

Assistive Technology Request

Technology Training Request

Technical Support Request

Complete if Technical Support is selected in Queston 17.

Primary Functional Goal

Supporting Documentation

Acknowledgement of Terms and Conditions

Acknowledgement of Documentation

Signature