The following would like to receive English / Punjabi tapes (delete as required)


Full name:
Mr / Mrs / Miss ..........................................................................................................

Address.....................................................................................................................

....................................................................................................................................

...........................................................................Post Code.......................................

Telephone number (or contact number)...................................................................

Is the applicant registered blind?...........................................................................
(if the applicant is not registered blind or visually impaired, this application must
be accompanied by confirmation by an ophthalmologist, doctor, ophthalmic optician,
social worker or similar professional person stating that the applicant's close-up
vision with spectacles is N12 or less. This is necessary in order to comply with
postal regulations concerning free postage of "articles for the blind".)


We use standard audio cassette tapes which can be played on any domestic
cassette player. If you do not own a cassette player we can lend you one.

Do you wish to borrow a cassette player? YES / NO

Signature.................................................

Date.........................................................
(If signing on behalf of the applicant, please print your name and your connection with the applicant.