A/G Center for the Blind

AG Center for the Blind
1445 N Boonville Ave
Springfield, MO 65802
Email: Blind@ag.org
Phone: 417-831-1964
Fax: 417-862-5120

Register with the A/G Center for the Blind

Registration with us is necessary before you can receive our resources and services. Fields that begin with an asterisk (*) are required to be filled in.

*This registration is for an:	Individual Organization
*Last Name:
*First Name:
*Email Address:
*Address:
*City:
*State:
*Zip Code:
*Phone:	(include your area code)
*Gender:	Male Female
*Date of Birth:
*Do you read Braille?	Yes No
*Reading Preferences?	Cassette Braille Large Print
*Are you legally blind?	Yes No
	If no, please explain:
Church Name:
Pastor's Name:
Church Address:
Church Denomination or Affiliation:
How did you find out about the Assemblies of God National Library for the Blind?
If you would like a book catalog, please select your media choice:	Large Print Braille Cassette
Which of our services would you be interested in?	Devotionals God's Word for Today Take Five Periodicals Club Connection Live Pentecostal Evangel Woman's Touch Heritage High Adventure HonorBound On Course (Youth) Braille Services Adult Student Braille Pentecostal Digest Sunday School Quarterlies Adult Student Guide Adult Teacher's Guide High School Spirit Study Guide High School Teacher Guide Pathways for Young Adults Student Guide Pathways for Young Adults Teacher Guide Pre-Teen Student Guide Pre-Teen Teacher Guide Primary Teacher Guide Young Teen Study Guide Young Teen Teacher Guide Other Services Berean Colleges Library Books
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