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Apply for a Radio

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To order a radio, free of charge, for those who have a visual or physical impairment that prevents them from reading: 

Fill out the form below to receive our programming.  If you have any other questions, they can be directed to (402) 572-3003. We are located at 7101 Newport Ave. Suite 205 Omaha, NE 68152.

Contact Information
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I hereby authorize the release of pertinent data by agency, organization, physician, or clinic to determine my eligibility for the Radio Talking Book Service. I am aware that the receiver is on loan to me and remains the property of the Radio Talking Book Service. If I move or change my telephone number, I will notify Radio Talking Book Service. If the receiver is no longer needed or used, I will return it to the Radio Talking Book Service.

*REQUIRED
Eligibility Requirements

  1. Blind persons whose visual acuity, as determined by competent authority, is 20/200 or less in the better eye with correcting lenses, or whose widest diameter of visual field subtends an angular distance no greater than 20 degrees.
  2. Other persons with physical disabilities as follows:
    • Persons whose visual disability, with correction and regardless of optical measurement, is certified by competent authority as preventing the reading of standard printed material.
    • Persons certified by competent authority as unable to read, see, or handle standard printed material as a result of physical limitation.
    • Persons certified by competent authority as having a reading disability resulting from organic dysfunction and of sufficient severity to prevent their reading printed material in a normal manner.

This portion must contain the contact information of a physician, nurse, counselor, clergy, or other qualified professional, or an officer of an organization of or for the blind, visually impaired or physically disabled (such as the NCBVI, etc) who can verify the eligibility of the applicant.

Contact persons should be someone with whom you regularly communicate and who know you have given us their name.
Please fill out both sections. This information is very important.

Please include your Name, Relationship, Address, Phone and Email Address
*REQUIRED
Please include your Name, Relationship, Address, Phone and Email Address
*REQUIRED
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