Future
Reflections
The National Federation of the Blind
Magazine for Parents of Blind Children
1800 Johnson Street * Baltimore, Maryland
21230 * (410) 659-9314
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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
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[�� ]New Subscription�� [��
]Renewal�� [�� ]Address or other change
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