Future Reflections                                                                                           Convention 2004

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Free Braille Books Program
Application

To apply for the program, please send the information requested in the application below to:

AAF Free Braille Books Program
1800 Johnson Street
Baltimore, Maryland 21230|
Telephone: (410) 659-9314, extension 361
Fax: (410) 685-5653
<brailleaction@nfb.org>
<www.actionfund.org>

Name __________________________________________________________________

Address ________________________________________________________________

City, State, Zip ___________________________________________________________

(check one) [  ] student, [  ] teacher, [  ] library or other institution

If student, birth date __________________________

Name of parent(s) ________________________________________________________

________________________________________________________________________

[ ] Yes, send me the Junie B. Jones chapter books (RL 2.0). I understand six books will be issued in 2004.

[ ] Yes, send me the A to Z MysTerieS® chapter books (RL 2.6). I understand six books will be issued in 2004.

[ ] Yes, send me the sports biography books written by Matt Christopher for preteens.
I understand six books will be issued in 2004.

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