Customer Request - RNIB

Online Today and Technology Support help form

If you would like to contact us, please fill in the help request form below, ring us on 0303 123 9999 or email your message to onlinetoday@rnib.org.uk

We will only use your personal details in relation to your request to use our services as RNIB, RNIB Charity, Action For Blind People and Cardiff Institute for the Blind.
We will not pass your information on to third parties. We will store records of the assistance we have given you but will only use this to provide a history of the support
you received in the past to our staff or volunteers.

All fields marked * are mandatory.

 

Your Details

Salutation: *
First Name: *
Last Name: *
Home Phone: *
Mobile:

Email:

Street Line 1: *

Street Line 2:

City: *

County: *

Post Code: *

 

About your problem

What do you need help with: *
What kind of device do you need help with:
Further information:

 

About You

The Big Lottery fund has given us money to provide this service. We need to show them that we are helping people of all ages and from different backgrounds so we’d like to ask you a few additional questions about yourself. All the information you give us is completely confidential.

Gender: *

Disability: *

Age: *

Ethnicity: *

Religion: *

Sexual Orientation: *

 

Keep in touch


RNIB, RNIB Charity, Action for Blind People and Cardiff Institute for the Blind would occasionally like to keep you updated about our products and services. Are you happy to be contacted by us and receive this information?


Are you happy to receive the information by post?


If yes to post, which format?


Are you happy to receive information by email?


If yes to email, which format?


Are you happy to receive the information by phone?

 

If you are requesting help for someone else, please tick this box and complete the section below:

First Name: *

Last Name: *

Organisation:

Email: *

Would you like to be kept updated about this request by email:

Phone: *

Street Line 1: *

Street Line 2:

City: *

County: *

Post Code: *


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