Badger Accessibility Services Registered LogoRegistration Form

Fill out the following form to register to use Badger Accessibility Services (BAS). We will create your account and email you with the login and password to access the system. There is no cost to register. The only costs incure when you submit conversion requests. Any non-profit municipality or educational institution is available to register.

Office hours are 8 AM - 4:30 PM CST Weekdays.

Organization Description

School Name*

Department Name*

City*

State Abbreviation*

Internet Address

Main Contact Information

You will be able to add additional users once your account had been created.

First Name*

Last Name*

Position

Street Address Line 1*

Address Line 2

City*

State Abbreviation*

Zip code*

Phone number*

Mobile Number

Fax number

Email address*

Does this contact want to receive the billing invoices?**

Does this contact want to receive email order confirmations?**

Security Check: In order to cut down on spam, please enter the word(s)/number(s) in the box.*