Register for Services

In order to become a registered patron, this one page application must be filled out. There is no fee to sign up, and all of our materials are provided free of charge. At the bottom of the application there is a certification section which must be completed by any of the following: a doctor of medicine, doctor of osteopathy, ophthalmologist, optometrist, nurse, therapist, librarian, your parish priest, or a professional staff member of a hospital, institution, or social welfare agency. If you have a form from your doctor verifying your disability, that can be submitted with the application instead of a signature. Similarly, if you are a patron of another organization serving the blind and visually impaired and have a form from that organization, that will suffice as well.

The form can be filled out online, printed, certified and scanned back to us at clientservices@xaviersocietyfortheblind.org. It may also be snail-mailed back to us. Once we receive the application, we will contact you to let you know that you have become a patron.

If you have any questions about registering or need more information please do not hesitate to contact us. We can be reached Monday to Friday 8:30 a.m. to 4:30 p.m. ET at 800-637-9193 or 212-473-7800. If you get our answering machine during operating hours, we are on another call so please leave a message and we will get back to you as soon as we can. Alternatively, we can be reached via e-mail: info@xaviersocietyfortheblind.org.