Author: Robert Gardner
Last saved by: Sariah Mattinson

REGISTRATION FORM
2015 Illinois Braille Readers Are Leaders (iBRAL) Contest
for Blind Youth of Illinois

Sponsored by the National Federation of the Blind of Illinois (NFBI)

***

CONTESTANT INFORMATION

Last Name:  Mattinson

First Name:  Sydney	

DOB:  August 5, 2008

Grade in School:  1^st Grade

Parent(s)/Guardian Name: Sariah & Jake Mattinson 

Address:  3330 Sunnyside Ave., Brookfield, IL  60513

Phone:  630-697-7563

E-mail:  sariahmattinson@gmail.cm

School Contestant Attends (public, private, home, or specialized):   

School Name: Salt Creek Elementary

School City & State: Elmhurst, IL

INFORMATION FOR CERTIFYING OFFICIAL 

Name:  Sariah Mattinson

Address:  3330 Sunnyside Ave., Brookfield, IL  60513

Phone:  630-697-7563

E-mail:  sariahmattinson@gmail.com

Relationship to Contestant:  Mother

***

Name & address to send certificate & any prizes to:  

Sydney Mattinson
3330 Sunnyside Ave.
Brookfield, IL  60513

***

Please submit completed form between November 1, 2014, and January 19, 2015

E-mail to: ibralcontest@gmail.com

or mail to:  
iBRAL Contest
attn:  Deborah Stein
5817 N. Nina
Chicago, IL 60631

***

THE KELLY DOTY AWARD
This award will be presented to a student who has overcome multiple handicaps to become Braille literate. Please see the contest rules for a complete description of those eligible.  If a certifying official would like to nominate a contestant for this award, please present a short rationale below.