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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