Convention Registration

Everyone attending any portion of the MCB convention must be registered. You can register prior to the convention electronically by filling-out and submiting the On-line Registration Form on this page or you can download and complete the Mail-In Registration Form below. You can also register in person during the convention at the registration table.

Registrations that are electronically submitted or postmarked on or before September 7, 2011 will be charged the discounted Registration Fee of $5.00. Registrations that are electronically submitted or postmarked after September 7, 2011, or submitted in person at the convention will be charged the regular Registration Fee of $15.00.

IMPORTANT NOTE: The following registration forms have nothing to do with your hotel reservations. The forms are for MCB Convention events. You need to make your Hotel Reservations separately and directly with the hotel. Changes or cancellations (including hotel) are due no later than September 7, 2011.

Mail-in Registration Form

To register by mail, download and print the following Microsoft Word document. Please read the form carefully and provide all information. Mail completed registration forms, with payment, to Missouri Council of the Blind, 5453 Chippewa, St. Louis, MO 63109

On-line Registration Form

This online form allows you to register for the 2011 MCB State Convention. The form automatically calculates the total fees due at the end of the form according to the selections you make. If any entry errors are detected after you press the submit button, an error message describing the entry errors will be displayed. Simply correct the errors described and click the submit button again to continue.

Registrant Information
Special Requirements:

Please Check All that Apply:

Media Preference:
Break Away Sessions:

On Friday, October 14th at 4:00 PM, we will have two break away sessions for you to choose from.

  • Basic Self Defense: Presented by Team Joplin Martial Arts teacher, Mickey Seeten; third degree black belt
  • Storm Safety: Presented by the Redding Fire Department. Safety measures during fire, tornado, storm, etc.

So that we may know the number of attendees for each session, please indicate which session you would like to attend.

Hospitality Dinner:

The hospitality dinner will be held on Friday evening October 14, 2011. A fee of $5.00 will be charged for each person attending the dinner. The menu includes a Club Sandwich, Potato Chips, Brownie, Fruit Cup and beverage.

Convention Banquet:

The convention banquet will be held on Saturday evening October 15, 2011. A fee of $20.00 will be charged for each person attending the banquet. There are two dinner entrees to choose from: Sliced Top Round Beef or Baked Seasoned Chicken. Entrees include house salad with choice of dressing, Rosemary New Potatoes, Fire Roasted Vegetable Medley and warm rolls with butter. Dessert is choice of assorted fruit pies. Coffee and iced tea will also be served. If needed, you may also request an diabetic or vegetarian dinner.

Convention Registration:

The pre-registration fee is $5.00 for each person. The pre-registration deadline is September 7, 2011. After the pre-registration deadline passes, the on-site registration fee of $15.00 will be charged for each person. Any registration forms electronically submitted or received postmarked later than September 7, 2011 will not be accepted as pre-registration.

Total Fees:

Total calculated fees due:

On-line Form Submission:

Below you will find two buttons; the Print and Mail button and the Submit On-Line button. If you select the Print and Mail button, a popup window will open containing the completed form and your computers printer dialog box will be activated so you can print out the form and mail it to the MCB office along with your check for the registration fees. If you select the Submit On-Line button, your application will be electronically submitted to the MCB office and you will be transferred to the Pay Pal web site to pay the registration fees using your credit card, debit card or Pay Pal account. Please Note: There is a convenience fee of approximately 3 percent added to payments made on-line.

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