* indicates a required field Tell us a little about yourself! I am a Parent / guardian I am an educational support person Child’s name* Child's date of birth* Gender Male Female Postal address Address City State Post code Parent(s) name* Phone Email* Any further information about your child’s vision or interests Terms and Conditions Loan period for all kits is 2 months. Please return all kit items in good, clean condition. General wear and tear to kits is expected, but please return all items. Vision Australia Library reserves the right to charge for lost kits. Feelix kits remain the property of Vision Australia Library and are not to be sold, copied or loaned. Membership will be reviewed for eligibility. I understand these terms and conditions and agree to return the Feelix kit by the due date indicated.* Parent(s) name* Date:* Are you Teacher Allied health professional Other Please specify Name* School/organisation* Child’s name* Child’s age* Postal address Address City State Post code Phone Your email* Braille required Contracted Uncontracted Either Any further information about your student’s/client’s vision or interests Terms and Conditions Student/client must be a client of Vision Australia. Loan period for all kits is 2 months. Please return all kit items in good, clean condition. General wear and tear to kits is expected, but please return all items. Vision Australia Library reserves the right to charge for lost kits. Feelix kits remain the property of Vision Australia Library and are not to be sold, copied or loaned. Teacher kits are not to be sent home with clients and remain the responsibility of the loaning teacher. Membership will be reviewed for eligibility I understand these terms and conditions and agree to return the Feelix kit by the due date indicated.* Your name* Date:* Leave this field blank