Name:
Address:
Phone Number:
E-Mail Address:
Legally Blind: ____ Visually Impaired: ____ Fully Sighted: ____
Format for Braille Forum (ACB National’s Newsletter): LP, Half Speed Cassette, Computer Disk, Braille or E-mail
Format for NJCB Chronicle: LP__, Cassette__, E-Mail__
Annual Dues due in January
Individual membership: $10.00
Corporate Membership: $25.00
Make check payable to MCAB and send to Larry Morgan , Treasurer at the above address. If you have any questions, call Ottilie at (609) 882-2446
Sincerely,
Ottilie Lucas, President