Subscription/Donation Form

The Voice of the Diabetic is a quarterly magazine published by The Diabetics
Division of the National Federation of the Blind (NFB) for anyone interested
in diabetes, especially diabetics who are blind or losing vision. It is an
outreach publication emphasizing good diabetes control, diet and independence.
Donations are gladly accepted and appreciated. Contributions are not only tax
deductible but are needed to keep the Voice and the Diabetics Division moving
forward to help people with all aspects of diabetes.
Members of the NFB Diabetics Division enjoy priority services and unique
benefits such as a continuous free subscription to the Voice, automatic access
to committees covering all aspects of diabetes, free counseling concerning all
facets of blindness and diabetes as well as access to diabetics who have
experienced complications.
The Voice is free to any interested person upon request. Each subscription
costs the Diabetics Division approximately $20 per year. To help defray
publication expenses, members are invited, and nonmembers are requested, to
cover the subscription cost.

To begin receiving the Voice, please check one:

[  ] I would like to become a member of the NFB Diabetics Division and
receive the Voice of the Diabetic. (Members are entitled to special membership
benefits.)

[  ] I would like to receive the Voice of the Diabetic as a nonmember.
(Nonmembers are encouraged to pay the institutional rate of $20/one year;
$35/two years; $50/three years.)

Send the Voice in (check one):

[  ] print[  ]   cassette tape for the blind and physically handicapped
[  ] both (recorded at slower-than-standard speed of 15/16 IPS)

Optionally check this box:

[  ] I would like to make (or add) a tax-deductible contribution of $
___________ to The Diabetics Division of NFB.

Please print clearly

Name 

Address   

City ______________________________________ State ________________________ Zip
     

Telephone ( _______ )

Send this form or a facsimile to:
Voice of the Diabetic, 811 Cherry St., Suite 309, Columbia, MO 65201

Please make all checks payable to:
NATIONAL FEDERATION OF THE BLIND