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Our weekly USB memory stick recordings will play on computers, on digital radios with USB sockets, and on special USB player units. Our service is also directly available, without application, online at: www.wstn.org.uk and by telephone: 01743 387487 _____________________________________________________ 1. Please have your name and contact details completed below.. 2. Please have the relevant certificate completed overleaf. 3. If you live within the western half of Shropshire please tick the box if you do not have any of the above means of playing a memory stick and we will provide a player on free loan. 4.

(Our loan players are not provided outside our west Shropshire area)

Send your application to our address above.

_________________________________________________________________________________________

NAME

ADDRESS

___________________________________________ ___________________________________________ ___________________________________________

___________________________________________ POSTCODE ___________________________________________ TELEPHONE NO. ___________________________________________ EMAIL ___________________________________________ Royal Mail Regulations require that one of the Certificates overleaf is completed before we can use the ‘Articles for the Blind’ free post. _____________________________________________Page 1 of 2 WSTN Application Form Mar17AW


CONFIDENTIAL ~ W S T N APPLICATION

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Royal Mail Regulations require that one of the Certificates below is completed before we can use the ‘Articles for the Blind’ free post.

_____________________________________________________ FOR REGISTERED BLIND APPLICANTS I confirm that the applicant named overleaf is Registered Blind. SIGNATURE ___________________________________________ NAME and LOCAL AUTHORITY POST HELD (please print) ___________________________________________ DATE ___________________________________________ ADDRESS ___________________________________________ ___________________________________________

FOR PARTIALLY-SIGHTED APPLICANTS I confirm that the applicant named overleaf has close-up vision with spectacles which is N12 or less. SIGNATURE ___________________________________________ NAME and QUALIFICATIONS (please print) Opthalmologist/Doctor/Opthalmic Optician ___________________________________________ DATE ___________________________________________ ADDRESS ___________________________________________ ___________________________________________ ___________________________________________

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Charity Registration No. 504996 WSTN Application Form Oct12AW

Wstn application form mar17  

West Shropshire Talking Newspaper application form for free USB memory stick service via Royal Mail

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