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.

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