Associated Services for the Blind

Recordings: Order Form

Please fill in your information on the form below. When you submit the form, you will receive onscreen the form in a print-ready format.
Please review the form and sign the form (if you are submitting your credit card information).
Please print out and mail the form to ASB. Please don't forget your check.

Please make your magazine selection(s):

	Anthropology/Archeology - $36.00 Civil War Times Illustrated - $28.00 Family Circle Magazine - $42.00 Family Handyman Magazine - $36.00 Forbes Business Magazine - $57.00 Fortune Business Magazine - $57.00 Gardening How-To Magazine - $36.00 Harvard Men's Health Watch - $36.00 Harvard Women's Health Watch - $36.00 Monthly Time Magazine - $36.00 Ms Magazine - $36.00 New Yorker Magazine - $36.00 O - The Oprah Magazine - $36.00 PC World Computer Magazine - $36.00 Pennsylvania Magazine - $28.00 Popular Mechanics Magazine - $36.00 Popular Science Magazine - $36.00 Psychology Today Magazine - $30.00 Radio Digest - $36.00 Science News Magazine - $48.00 Science and Medicine - $48.00 Scientific American Magazine - $48.00 Skeptical Inquirer Magazine - $30.00 Smart Money Magazine - $36.00 Smithsonian Magazine - $36.00 Taste of Home Cooking - $28.00 Trains Magazine - $36.00

We accept cash, check, money order, Visa, or MasterCard.

First Name:
Last Name:
Address:
City:
State:
Zip Code:
Telephone:

Would you like Brailled Labels on your cassettes? Yes No

I would like to charge my account listed below:
	MasterCard Visa
Name of Card Holder:
Account Number:
Expiration Date:
Full Address:	(If different than above):
Phone:	(If different than above):

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	Copyright 1995-2003. All rights reserved. Associated Services for the Blind, 919 Walnut Street, Philadelphia, PA 19107 Phone: (215) 627-0600 \| Fax: (215) 922-0692
	Disclaimer: The information contained in these pages is provided as a courtesy by Associated Services for the Blind (ASB). ASB expressly disclaims any representation or warranty express or implied concerning the accuracy, completeness or fitness for a particular purpose of the information. Persons accessing this information assume full responsibility for the use of the information and understand and agree that ASB is not responsible or liable for any claim, loss or damage arising from the use of the information. Reference to specific products, processes, or services do not constitute or imply recommendation or endorsement by the ASB. The views and opinions of the information contributors do not necessarily state or reflect those of the ASB.