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Free White Cane Program

Thank you for your interest in the Free White Cane Program... Please fill out the required information below to receive your free cane. For questions regarding the Free Cane Program email us at [email protected].

*Required field(s) are indicated by an .**
* First Name:
* Last Name:
* Address:
Address 2:
* City:
* State:	* Zip Code:
* Phone:
* Birth Date:	* Birth Month: * Birth Day: * Birth Year:
* Email:
* Verify Email:
* Member of NFB?
* Braille Reader?
Cane Sizing
For starter canes: measure to your armpit. Seasoned travelers: measure to your chin or higher. Further information about cane sizing.
* Select Cane Size:
Acknowledgement
By requesting this white cane I acknowledge that: It must be more than six months since your previous request for a white cane. I am blind or visually impaired, and this cane is for my personal use; OR I am making this request on behalf of a child under the age of eighteen who is blind or visually impaired, and the cane is for his/her personal use. By selecting the checkbox below marked "I Accept", you acknowledge that you have reviewed and agree to all of the statements above. * I Accept

Free White Cane Program

Cane Sizing

Acknowledgement