Radio Reading Network
Radio Reading Network
OF MARYLAND
3501 Taylor Avenue, Baltimore, MD 21236
410-779-4969 · Fax: 410-779-4967
E-mail: info@
LISTENER APPLICATION
I. LISTENER INFORMATION
Circle: Mrs. Ms. Miss Mr. Dr. Other ______ BIRTHDATE ____________
NAME: LAST FIRST MI
HOME ADDRESS
CITY STATE ZIP
HOME PHONE
County: ___________________ E-Mail: ________________________________
Business Address: ___________________________________________________
__________________________________________________________________
City: ___________________State: _____ Zip: _______ Phone:_______________
Fee: $50.00 per year; $25.00 billed every 6 months. (A full or partial fee waiver will be granted to anyone whose financial resources are limited.)
Waiver Requested Payment Enclosed $________
Please make check payable to: Radio Reading Network of Maryland
If you wish future bills sent to someone else, please indicate below:
Circle: Mrs. Ms. Miss Mr. Dr. Other ______
BILL TO: LAST FIRST MI
HOME ADDRESS
CITY STATE ZIP
Kindly provide the names of two (2) people who have agreed to be contacted in regard to your service, if necessary. At least one “Alternate’s” address should be different from the Applicant’s.
ALTERNATE 1:
NAME: LAST FIRST MI
HOME ADDRESS
CITY STATE ZIP
HOME PHONE
RELATIONSHIP TO APPLICANT
ALTERNATE 2:
NAME:
HOME ADDRESS
CITY STATE ZIP
HOME PHONE
WORK PHONE
RELATIONSHIP TO APPLICANT
SERVICE AGREEMENT
I understand that the radio I receive remains the property of the Radio Reading Network of Maryland and is to be returned if I no longer use the radio.
Applicant Signature
II. GENERAL INFORMATION
How did you hear about the Radio Reading Network of Maryland?
Doctor ____ Radio ____ TV ____
Newspaper ____ Friend ____ Other ____
Are you a Veteran? Yes ____ No ____
Are you registered for the Library of Congress, Talking Books Program?
Yes ____ No ____
If you wish to apply to Talking Books, call 410-230-2424.
Radio Reading Network
OF MARYLAND
3501 Taylor Avenue, Baltimore, MD 21236
Office: 410 - 779-4969 · Fax: 410 - 779-4967
E-mail: radioreading@
The Radio Reading Network of Maryland is an independent non-profit organization which serves persons who are either visually or physically impaired to the degree that they are unable to read for themselves. Nearly seventy Volunteers read today’s newspapers and magazines today. This unique service is broadcast on sub-carriers of WBJC in Baltimore, WFWM in Frostburg and WESM in Princess Anne.
Programs are heard by means of a special receiver available through the Radio Reading Network. There is an annual fee of $50 payable in two installments. However, in a case of need, the fee can be waived.
A schedule of weekly programs is sent to each Listener on the mailing list.
For daily program information . . . to apply for a receiver . . . to volunteer as a Reader . . . or to contribute, call the Radio Reading Network of Maryland at 410-779-4969.
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For Office Use Only:
Receiver #:
Date:
Listener #:
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