KABVI Membership Application

I am enclosing 250.00 for my life membership to KABVI  

I am including a tax deductible donation to KABVI in the amount of 

$

TOTAL AMOUNT ENCLOSED  $

Name: First  Mid. Init. Last

Address: 

City: 

State:               Zip: 

Phone:           E Mail Address 

Are You:

Legally Blind               Visually Impaired  

Deaf-Blind                    Sighted 

I would like the KABVI NEWS and the BRAILLE FORUM in:

Braille               Large Print  

Disk                   Cassette  

Regular Print               E Mail  

I do not want these publications  

                     back to top