The National Association of Blind Veterans
WE ARE A DIVISION OF THE NATIONAL FEDERATION OF THE BLIND
"BLIND VETS SERVING BLIND VETS"

Membership Application

APPLICATION-(please print this page)


1. Name:_____________________

2. Address:___________________
 
 

3. City:______________________

4. State:______________________
Zip:_________________________

5. Telephone:__________________
Cell:__________________________
 
6. Email:_______________________
 
7. D.O.B: (month and day only)_____________________________

8. Spouse:_____________________

9. Emergency Contact:___________

10. Special Interests::___________

11. Veteran:_____Yes _____No
Ifyes:BOS____________________

12. NFB Member: ____Yes ___No
If yes State /Chapter___________

13. Special Interests:


Dues are $5.00 per year  or $100
for Life Member as specified by the National Board.
Make Checks payable to: NABV
Mail Checks and application to: NABV ,
PO Box 784957 
Winter Garden, Fl. 34778