SHARE SUCCESS STORIES

We want to hear your story!  Tell us how your experience with BSBP and/or MRS helped you in your life.

WORKING WITH THE BUREAU OF SERVICES FOR BLIND PERSONS (BSBP) AND/OR MICHIGAN REHABILITATION SERVICES (MRS)
So we can contact you about your story
BSBP/MRS District Office
First/Last name of BSBP/MRS Counselor
TELL US YOUR STORY!
We want to hear your Success Story about your experiences with BSBP/MRS.
(For example: Assistive Technology solutions, training, education, greater independence in the home or classroom, newly acquired job, return to work, etc.)
A "Success Story Picture" - if you have one, please upload it here so we can use it along with your story.
At work / with BSBP/MRS counselor / other
RELEASE OF INFORMATION form
FOR CUSTOMERS: So we may share your story... download, print, fill out, and sign the RELEASE OF INFORMATION FORM at the bottom of this page to indicate the following: I am granting the Bureau of Services for Blind Persons (BSBP) and/or Michigan Rehabilitation Services (MRS) the right to use my success story and/or photograph for the purpose of providing public information / public education materials about BSBP and/or MRS. Send completed form to: Michigan Council for Rehabilitation Services 3490 Belle Chase Way, Suite 110 Lansing, MI 48911-4263
Please contact our office if you need assistance in completing this form or if you have any questions.
Our office numbers are 877.335.9370 or 517.887.9370
THANKS SO MUCH FOR SHARING YOUR SUCCESS STORY AND HELPING US TO BE SUCCESSFUL WITH THIS VERY IMPORTANT PROJECT.
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RELEASE OF INFORMATION form.doc108.5 KB