To apply, please send the following information by mail, email, or fax to:

AAF Free Braille Books Program
1800 Johnson Street
Baltimore, Maryland 212230
Telephone: (410) 659-9315, 2360 or 2361
Fax: (410) 659-5129
BrailleAction@actionfund.org
www.actionfund.org

Date _________ Name of applicant __________________________________
Check one: [ ] Student [ ]Teacher [ ]Library or other institution

If student, the following information is required:
Birth date ____________Name of parent ________________________________

Please ship the books to:
Name _____________________________________________________________
Address ___________________________________________________________
City, State, Zip ______________________________________________________

Other contact information (optional)
Phone number(s) ____________________________________________________
Email address ______________________________________________________

Please check your choice or choices below. All applicants may select one, two, or all three of the book series offered. Please use a separate form for each applicant, even if the books are shipped to the same location. The books are FREE, and they are for the applicant to KEEP. These selections are available from January 2006 through December 2006.

[ ] Jigsaw Jones Mystery® chapter books (grades 2-4). Shipped every other month.

[ ] Matt Christopher sports books for youth (grade 5 and up): three non-fiction, Legends in Sports; and three fiction books featuring popular extreme sports. Shipped every other month.

[ ] Sampler set of chapter books from four different reading series (grades 2-4): SpongeBob SquarePants®; Franny K. Stein, Mad Scientist; My Weird School; and Ready, Freddy! Shipped every other month.

Please make copies as needed!