Future Reflections Winter/Spring 2000, Vol. 19 No. 1

(back)(contents)

 

Future Reflections

The National Federation of the Blind Magazine for Parents of Blind Children

1800 Johnson Street * Baltimore, Maryland 21230 * (410) 659-9314

New Subscriptions    *   Renewals   *    Address Changes

 

Date: ________________________Phone number(s):________________________________                      

Name:_________________________________________________________________________

Address:____________________________________________________________________

City:___________________________________State:______________Zip:____________________

Name of child:________________________________________Birth date:_________________

[  ] Parent  [  ]Teacher  [  ]Other_____________________________________

 

[  ]$8.00 Subscription and family membership in the National Organization of             Parents of Blind Children

[    ]$15.00 Non-member subscription

 

This is a: [   ]New Subscription   [   ]Renewal   [   ]Address or other change

 

I prefer the following format(s): [   ]Large print  [   ]Cassette tape   [   ]Both

 

Changes: Please print old or duplicate name and/or address as it appears on your magazine label in the space provided below. Please let us know if this is an old name/address to be changed to the one given above, or if it is a duplicate that you wish deleted.

_________________________________________________________________________

 

_____________________________________________________________________

 

  (back)(contents)